Journey Camp Registration Form
1. Name of Child: First Last Gender: Male / Female
2. Grade they will be entering in Sept 2009: 2 3 4 5 6 7 8 9 10 11
3. Age as of June 2009:
4. Name of Parent(s) or Guardians:
5. Important: Have you read the Note to Parents? No Yes
6. Contact Information:
Parent 1
Your Mailing Address (with Zip):
Your Email:
Home Phone:
Work Phone:
Parent 2
7. Session(s) you are registering for: Three Week for Boys and Girls: July 6 –24 Girls Week: August 10–14 Teen Leadership at Girls Week: Teen Weekend August 8-9, and then Girls Week August 10-14 Moonseed Overnight Weekend for Girls: August 7-9
8. Payment: Choose One I agree to send half the cost March 1st and half May 1st. I will send payment in full this month. I will email my plan for a different payment schedule. I will pay half the cost by May 1st and email a half scholarship application.
Finances: Please make a contribution toward our scholarship fund if able. Check here if you are sending a letter to apply for a partial scholarship.
10. Support at Camp: Please reply below or email a longer letter.
a. Any medical, physical, health needs such as food allergies, medications, or special physical needs or restrictions? b. We want every camper to have our support. Are there any current issues or needs we should be aware of? c. What assistance will your child need in following the conduct code?
a. Any medical, physical, health needs such as food allergies, medications, or special physical needs or restrictions?
b. We want every camper to have our support. Are there any current issues or needs we should be aware of?
c. What assistance will your child need in following the conduct code?
NOTE: Email registrations are not complete until the $50 registration fee is received. Please send $50 for each child and each session. It goes toward the final fee.
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