RESERVATIONS

 

Please use our Calendar to help you pick available weeks. You may click here to access our larger calendar.

 

RESERVATION FORM  -You may also click here for our printable form to mail or fax to us.

 

"Get Adobe Reader"

 

Please enter the week you have selected to enroll your child/children in our Summer Day Camp program.

 

Contact person

 

How did you find us? :

Choose one of the following options:

Customer
Friend
Magazine Advertisement? Which one?

Mag. name

Other?

   

 

Please provide your information:

Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Work Phone

Cell Phone

Fax

Home Phone

E-mail

Number of children

 

Choose one of the following options: How do you wish to pay for your Day Camp?

Personal Check payable to Pine View Farm
Cash
Money Order
Credit Card

*If there is any thing you feel we should know about your planned reservation  please let us know:

  *It is very important to list for us any known allergies, reactions, medicine or special needs your child/children may have.
Please list Emergency Contact information here as well.
 

SECURITY Please type in the numbers 1 through 6

  THIS MUST BE ENTERED OR YOU WILL BE DIRECTED BACK HERE TO ENTER IT.

Please read carefully and sign below

 I have read, understand, and agree that by typing my name below in the "Type Name as Signature:" box and submitting this form to Pine View Farm that I  agree to being contacted for reservation confirmation and payment.

Note: Submitting this form does not confirm your reservation.

Type Name as Signature:    

THIS MUST BE ENTERED OR YOU WILL BE DIRECTED BACK TO ENTER IT.

 

 

Please remember to wear proper farm attire. (No sandals or open toe shoes permitted)

No-No's at Pine View Farm - No Smoking, No Adult Beverages, & No Pinatas

 

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