Camper Registration Form

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Name *

First

Last

I Am a: *

If a Person UNDER 18 years of age, you must be accompanied by a legal person OVER the age of 18 years of age.

Email *

Full Mailing Address (123 Main St. Anywhere, USA 12345 *

Phone Number (Enter the BEST number to reach you on) *

Phone Number Above is: *

Does Rus-Men Farms Have Permission to Text You About This Event? *

Vehicle Make, Model, Color, License Plate Number *

If a Person UNDER 18 years of age, enter: “NOT DRIVING”

Date of Arrival (Not before Saturday April 6, 2024) *

Date of Departure (Not to exceed Tuesday April 9, 2024) *

Total Number of Campers Occupying Camp Site *

Enter the number of persons OVER & UNDER 18 years of age, If a Person UNDER 18 years of age, enter “I AM UNDER 18 YEARS OF AGE”

Type of Shelter *

If a Person UNDER 18 years of age, enter the correct option if you know it, otherwise check OTHER and enter “I AM A PERSON UNDER 18 YEARS OF AGE”

If OTHER was selected for Type of Shelter, explain below:

710 Iberia Rd. Galion, Ohio 44833

(419) 971-6957 | info@rusmenfarms.com