Application

First Name*

Last Name*

Organization*

Address*

Email*

Stated Purpose of Organization

Stated Purpose of Visit

Name

Phone (Home)

Phone (Work)

Cellular

Name

Phone (Home)

Phone (Work)

Cellular

Date Requested - From

To

Departure from Mainland:

Departure from Grace Island:

Booking Code*

Group Size

AMENITIES & EXTRA CHARGES

5 kayaks $10/day/1 boat

Wifi unlimited ($20/day)

Climbing Wall Staffing (1hr) $50/day

Snorkeling Gear $10/person/day

Speakers’ Cottage $200/week

Snorkeling Guide 2 hrs $60/session

Boat Runs to mainland $50 day

PLEASE CHECK ONCE DONE*

I have read and agree to The Cancellation Policy, and The Rental Agreement

Total Amount

$

Payment method

Credit/Debit Card

Billing Zipcode*

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Type*

Card Holder Name*

Camp Application

Contact #1:

Contact #2:

LOCAL CHARITY RATES "(*BERMUDA CHARITIES)"

REGULAR RENTAL RATES

REQUIRED $200 Refundable Breakage Fee

Grace Island Rate Summary

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