Dates Of Stay Use Fee Total Fees Collected Visitation
Date Last Name
Site
#
In Out
Total
#
Nights
Camp
2nd
Vehicl
e
Agency
Pass
Day
Use
Camp
Extra
Vehicle
Agency
Pass
Day
Use
No. Camp
Day
Use
Recieipt
#
Lisense # State
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Total (A+B+C+D+E):______________________________________
<Less> Credit Card Charges:_______________________________________
Cash For Deposit:___________________________________________
____________________________________________ Page:________
Page Completed By (Signature) Date
White Copy = CRC Office Yellow Copy = Area Manager/Host