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Registration for Mount Rainier Camp
Print out and mail to:
4405 29th st.
Mount Rainier, MD 20712
____Aug 17-21 ____ Aug 24-Aug 28
___ $115 for first camper, $100 for sibling
___ pay up to $40 w/'Anacostia Hours'
___ request $25-90 off for low-income or volunteer service
___ interested in aftercare
Name ______________________ Age ____
Name ______________________ Age ____
Address ____________________________
____________________________
Parent _____________________________
Ph ______________ ______________cell
Email ______________________________
Parent _____________________________
Ph ______________ ______________cell
Email ______________________________
Allergies/Medical conditions/ Diet restrictions
___________________________________
___________________________________
People authorized to pick up child:
_________________________ Ph _______
_________________________ Ph _______
___ OK to publish child's photo
Signature ___________________________
Enclosed $_________ Date___________
Co-directors Mary Joan & Jerry Park are
parents of six and trained as a teacher
and as a social worker/nurse.
Since l981 they have led thousands of
children, teachers and parents through
activities that build their skills of
Nonviolence – in peace camps,
workshops, family retreats and through
3 leader/parent guidebooks
Answer the Violence
with Skills for Peace
Little Friends for Peace
a 501(c)3 Nonprofit Corporation
