Northeast Rowing Center
 Information Form

 Last Name _______________________________________   First ______________________________

Please Print, Complete and Return by June 1st - Thanks

Under 18 Freeport Excursion Parental Permission

ð I give permission for my son/daughter to leave camp property and supervision for an excursion to Freeport on the Northeast chartered and monitored buses.

Parent’s/Guardian’s Signature ____________________________________________________

ð I do not give permission for my son/daughter to leave camp on the Freeport buses.

___________________________________________________________________

Airline Travelers - Will you be using the airport bus pickup?  ð Yes,   ð No

                      Date             Time             Airline                   Flight #
Arrival:        ___ /___        ___:___      ____________         ____________
Departure:   ___ /___        ___:___      ____________         ____________

Bus to/from Portland Jetport: Pickup at 3:00 PM (Saturday) - Drop off at 1:00 PM (Friday)
 ___________________________________________________________________

Auto Travelers - Will you be parking your auto at camp for the week?   ð Yes,   ð No

If Yes: Make _________________ Color ___________ Plate # ___________ State ____
 ___________________________________________________________________

Vegetarian Meals - Would you like vegetarian meals?   ð Yes,   ð No
___________________________________________________________________

Please return by June 1st to:   Northeast Rowing Center
                                             P.O. Box 2060  ·  Duxbury, MA 02331
___________________________________________________________________
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