The Indiana Lions of District 25-A, in participation with Indiana’s Parent, Youth and Sports Divisions of the National Federation of the Blind want to invite you to a weekend of fishing and camping for Blind and Low Vision Kids.

Date: June 23rd & 24th  Time:  Any time after 8:00am. on 23rd.  Welcome at 10:30am.

Location: 2222 S 900 West, La Porte, IN 46350

Registration Fee: Free. But we do ask you to contribute by checking the list below to find what item we’d like you to bring.

If your last name begins with A-I: couple bags of chips, J-R – bag of apples, oranges, etc.; S-Z: packs of juice drinks/non-carbonated drink or water.

Additionally, bring pillows, blankets, bug spray, sunscreen, hats, sunglasses, etc.

REGISTRATION DEADLINE: June 1st, 2012

_____________________________________ 	_____
Child’s Name				Age

_____________________________________	(_______)_____________________
Accompanying Parent/Gaurdian Name			Phone

 
Mailing Address					    City		               State	Zip
	
 
Please list any food and/or medical concern

_______________________
Parent/Guardian email

I waive and release all rights and claims that might be held against the Lions Of Indiana, Lions International, National Federation of the Blind of Indiana, National Federation of the Blind, community partners and all other sponsors and the hired or contracted producers, and any other volunteer(s) for any injury or losses suffered because of my participation or my child’s participation in this event. 



Signature of Parent or Guardian