Name ______________________  Phone _________________

Mail Address ________________________________________

City/State/Zip ________________________________________

E-mail Address _______________________________________

How many staying in your cabin?  ________
(cabin sleeps 6 -- one double bed + 2 sets of twin bunks)

Registration Fee:    Adult (age 18+)  $ 20.00 x ____adult(s)     =  $ _________
                               Child (age 3-17) $ 10.00 x ____ child(ren) =  $ _________
                                 or Family Cap  $ 75.00 x ____ (families) =  $ _________
                                                         TOTAL DUE                     =  $ _________

I wish to add a contribution toward the cost of operating the retreat: $ _________

                                                                TOTAL ENCLOSED          $ __________

Send reservations to:
      Mills Spring Ranch
      8000 Tower Hill Rd
      Casper, WY 82601

Or msrranger@hotmail.com