NADAC Agility Fun-Raiser/Seminar Camping Form
May 3-16, 2010
May 29-31, 2010


CAM-PLEX Multi-Event Facilities
1635 Reata Drive
Gillette, WY 82718
Office: 307-682-0552
Fax:     307-682-8418


**All Camp Sites are on CAM-PLEX Grounds**

If you have questions while completing this form, please call Barbara at
CAM-PLEX, 307-682-0552 or e-mail barbara@cam-plex.com

Please complete and print the form below. You can fax or mail it to the above address
to the attention of Barbara Steele.

                        RESERVATION INFORMATION

Name  
Address   
City/State/Zip  
Phone   
Arrival Date:    Departure Date:
Arrival Date:     Departure Date:      
   MM DD YY    MM DD YY

 Early arrival is available beginning May 3 & May 28, 2010
Campgrounds must be vacated by Tuesday, June 1 unless prior arrangements have been made.

 

CAMPING FEES
Handicapped?    Yes                         No

  CAMPING FEES - May 3-16 & May 29-31       

       

Quantity

Type of Service per day

 Number of Days

    Cost

 

Full Service Hookup @ $20.00 per day
(water, sewer, electric)

 

  

 

Water & Electric Hookup Only @ $17.00 per day
(sewer hook-up on site)

 

  

 

 Dry Camping  @ $12.00 per day
(no services)  

 

  

    2% Lodging Tax applies to all camping fees. 2%:
     5% Sales Tax applies to all camping fees.  5%:

TOTAL CAMPING:

  $  

** Reservations will not be accepted without payment in full**

 We accept Checks or Credit Cards (MasterCard or Visa only)
 *Please note - CAM-PLEX is also know as Campbell County Public Land Board and will appear        
on your credit card statement as such

Please select your form of payment 

Credit Card Number

 
Name as it appears on your card  

 Expiration Date (Required)
     

 

I agree that I am responsible for payment, and that my RV unit must be off CAM-PLEX grounds by 12:00 noon, June 1 unless prior arrangements have been made.  I agree, in consideration for being able to participate in this event, to release and to indemnify and hold harmless Campbell County Public Land Board, CAM-PLEX and its employees, from all liability for injury or damages to my person or property, or the property of persons who accompany me to this event.

 

Card Holder Signature:________________________________   Date: _________________