Bethpage Camp Resort Reservation Request
*First Name
*Last Name
*Address1
Address2
*City
*State
*Zip Code
*Phone
*Email
Group Name (if applicable)
*Arrival Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
*Arrival Date
1
2
3
4
5
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12
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17
18
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20
21
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24
25
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28
29
30
31
*Year
2012
2013
2014
*Departure Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
*Departure Date
1
2
3
4
5
6
7
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20
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22
23
24
25
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28
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30
31
*Year
2012
2013
2014
Requested Site Type
Full Hook-Up Site
Super Site
Special Site Requests
*Number of Adults
1
2
3
4
5
6
*Number of Children over 4 years of age
0
1
2
3
4
5
6
*Card Type
Visa
Master Card
*Card Number
*Card Expiration
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
*Year Expires
2012
2013
2014
2015
2016
2017
2018
2019
2020
*Digit Code on Back of Card
*Name as it appears on Card
Type of RV
Motor Home
Fifth Wheel
Travel Trailer
Pop-Up
Truck
Length of RV
Less than 20 ft
20-24 ft
25-29 ft
30-34 ft
35-39 ft
More than 40 ft
Have You Camped with Us Before?
Yes
No