2008 Des Moines County Conservation
Day Camps Registration Form

Please Use One Form Per Child - Do Not Put More Than One Child Per Form

Registration opens at 5:00 p.m. on Tuesday, April 24, at Starr’s Cave Nature Center.  
If you are unable to register at that time, mail this form and your check to:
Starr's Cave Nature Center, 11627 Starr’s Cave Road, Burlington IA  52601

 
Child's Name:   Child's Age:   Birth date:  
           
           
Address:  
   
   
City:     State:     Zip Code:  
               
               
Daytime Phone:  
   
   
Parents Name:  
   
   
Camp Name (First Choice):  
   
   
Date of Camp:  
   
   
Camp Name (Second Choice):  
   
   
Date of Camp:  
   
   
Fee:   (make checks payable to Partners for Conservation)
     
     
Receipt #: