Northstar Campground Seasonal Request Form

Northstar Campground
Seasonal Request Form

Please bear in mind that this form is strictly a Seasonal Site request. We will make every effort to respond to your request as promptly as possible. If space is available, we will telephone you to setup an on-site meeting. If space is unavailable, we will e-mail you our regrets. For this reason, it is necessary for you to include your home telephone number and a valid e-mail address with all Seasonal requests.

* Required Info.

First name	*
Last name	*
Middle initial
Year of Birth	*
Street address	*
Address (cont.)
City	*
State/Province	*
Zip/Postal code	*
Country
	Number where you can be reached *
Day Phone	Number where you can be reached *
	Don't forget the area code 000-000-0000
Evening Phone	*
Cell Phone
E-mail	*

Have you ever been convicted of a crime, other than a traffic violation? *
Yes No
If yes, explain

Seasonal Site Usage *

        Number of Adults
        Number of Children
        Number of Children under 3 years old

Open May 15 until October 15

Date of Arrival

        Are you bringing a pet or pets? *
        Yes   No
         If yes,
                 Name      Type     Breed     Weight

                 Name     Type     Breed     Weight
             *NOTE: No pets are allowed at any time on the premises without prior Management consent. NO EXCEPTIONS

Type of Camping Unit? *

Tent   Motor Home   Travel Trailer   Fifth Wheel   RV
Van Camper   Pickup Camper   Pop-up Camper   Other

Length of Camping Unit (pop-ups give length when open)

Do you have a slide-out? *
Yes    No

Vehicle Information *
List ALL motor vehicles, including recreational. To be kept on premises Make    Model    Color    Year    License Plate#    State
Make    Model    Color    Year    License Plate#    State

Make    Model    Color    Year    License Plate#    State

Personal References *
(List 3 persons, OTHER THAN YOUR RELATIVES, that we may contact to verity your character.)
Name     Relationship      Phone
Address     City     State    Zip

Name     Relationship      Phone

Address     City     State    Zip

Name     Relationship      Phone

Address     City     State    Zip

Emergency Contacts
(in an emergency we may contact- List 2 starting with nearest relative first.)
Name     Relationship      Phone

Address     City     State    Zip

Name     Relationship      Phone

Address     City     State    Zip

Please Provide your Employment Information Your Status: Full Time   Part Time Student Unemployed Retired
Employer

Employed as

How Long on Present Job?

Camping History Have you ever be a Seasonal Camper before?
If Yes, Please fill in below.

Previous campground
          State Located

   Reason for Leaving

         Length of Stay

Additional questions or comments

How did you hear about us?

       If "Other", please specify:

Would you like to be on our Email list?
Yes No

I certify that all the information given above is true and correct and understand that my seasonal site agreement may be terminated if I have made any material false or incomplete statements on this form.

Please remember that you do not have a seasonal site until it has been confirmed, and a seasonal site can not be confirmed until we meet in personal and authorized by management. If you do not here from us with in 24 hours please call our office 603-863-4001 (best hours 10:00am to 5:00pm.

Please Call
(603) 863-4001

Last revised: April 19, 2008