Camp Barry Shooting Sports Application

Chester Rod and Gun Club Barry Conservation Camp Parental Permission and Application Form for SHOOTING SPORTS WEEK

I hereby give my permission and consent to have:

__________________________          __________________
Camper’s full name (please print)            Age (must be 10 to 16 yrs on June 21)

attend the 4-H Shooting Sports session at Barry Conservation Camp on June 21 to June 26 2015 and I understand all 4-H Barry Camp requirements for this event, that my child has not won this in 2014, and that I am responsible for transportation to and from Barry Camp. I understand that Chester Rod and Gun club will pay the full tuition fee of $495 only.

________________________________________________________                 ________/2015
Parent or guardian’s signature                                                                                    (date)

__________________________________________________________
Print parent or guardian’s name

_____________________________________________________________
Print CRGC Member’s name and Badge number above

Address _______________________________________________________________________

Telephone no._________________________

Application must be postmarked no later than midnight March 13, 2015 Drawing to be held March 16, 2015 at the CRGC clubhouse.

Please mail to: Chester Rod and Gun Club, 99 Rod and Gun Club Rd Chester, NH 03036
                           ATTN: Camp Barry

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