Camp Bernie YMCA

Group/Organization Name*

Mailing Address

Primary Contact Name*

Alternate Contact Name

Primary Email*

Alternate Email

Primary Telephone *

Alternate Telephone

Requested Trip Dates or Time Frame

Arrival Time

Departure Time

Meals You’d Like Us to Include (If Any)

Expected No. of Attendees

Guaranteed Minimum No. of Attendees

Is your group going to be taking part in Camp Bernie activities, doing your own programming, or a mix of both?

How did you hear about us?

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