How many sessions at camp *

• 1/2 Session (1 week)
• 1 Session (2 weeks)
• 2 Sessions (4 weeks) +$100.00
• 3 Sessions (6 weeks) +$200.00
• 4 Sessions (8 weeks) +$300.00

Which session you will attend *

• Session 1 from June 25 - July 6 (No Camp 7/4)
• Session 2 from July 9 - July 20
• Session 3 from July 23 - August 3
• Session 4 from August 6 - August 17

If a half-session, which week you will attend

• Week 1 of Session
• Week 2 of Session

# Days Early Drop-Off

-- Please Select --1 2 3 4 5 6 7 8 9 10 15 20 25 30 35 40

# Days Late Pick-Up

-- Please Select --1 2 3 4 5 6 7 8 9 10 15 20 25 30 35 40

# of Lunches (In Addition to Cookouts)

-- Please Select --1 2 3 4 5 6 7 8 9 10 15 20 25 30

Camper's Name *

Age *

Date of Birth (MM/DD/YYYY) *

Gender *

• Male
• Female

Grade Completed by June 2012 *

Emergency Contact Name *

Emergency Contact Phone *

2nd Emergency Contact Name

2nd Emergency Contact Phone

Is this your first year? *

• Yes
• No

How did you find The Camp?

Maximum number of characters: 200

* Required Fields