Woodchuck Flat Campgrounds Online Request Form

* = Required
Question	Response
* Your Name:
Organizations Name:
* Address:
* City:
* State:
* Postal Code:
* Personal Phone Number:
Work Phone Number:
Fax Number:
E-mail Address:
Proof of current Liability Insurance submitted:	Yes No
* First Choice Date of Arrival:
* First Date of Departure:
Second Choice Date of Arrival:
Second Choice Date of Departure:
Total Number of Nights:
Minimum number of campers (youth and adults) 20 Maximum number of campers (youth and adults) 150
* Number of Adults:
* Number of Youth:
Please indicate any comments, special needs or requests:
* By submitting this reservation request, you hereby acknowledge that you have read and fully accept Woodchuck Flat rules and policies. Once the dates have been confirmed, a non-refundable deposit in the amount of $150.00 (one Hundred Fifty Dollar) will be required to secure your date payable to Placer/Nevada Counties Joint Camp. A complete listing of our campground rules may be read here: See the rules	Yes No