Seasonal / month application.- Kindly fill out form, print and mail with deposit to:
Daisy Barn Campground - 3101 West Lake Rd., PO Box 827 - Wilson, NY 14172
(716) 751-9375


Today's Date           
Name of Applicant  Phone No.
Permanent Address
Years There                   E-Mail

How many people will be staying with you        
Guests:             Frequent        Weekends        Occassional
Intended Use:  Full-time        Weekends        Occassional

Emergency Contact

Type of Camper       Year
Model       Length     Pullout Size

No. of Motor Vehicles
         Make Model
         Make Model

Do you presently have a valid drivers license?
Will you have a Boat on Site?                            
Do you intend to stay more than one year?      

Would you like to erect a storage unit?
Would you like to erect deck?    
Need a table or fire ring?

Any Pets? (no & size)

Have you been asked to vacate previous campsite 
Have you read and understood campground rules

_______________________________Internal Use ______________________________
Interviewed by                 Expected Site #
Comments     For Season #
          $ Deposit