Registration Form

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SIGN UP FOR EARTH CAMP 2008

* = Required information

*CHOOSE THE WEEKS BELOW:

Week 1 - June 16 - June 20 - Earth Explorers
Week 2 - June 23 - June 27 - Wild Life
Week 3 - June 30 - July 3 - Radical River (no camp July 4*)
Week 4 - July 7 - July 11 - A Bug's Life
Week 5 - July 14 - July 18 - Animal Adventures
Week 6 - July 21 - July 25 - Nature Survival
Week 7 - July 28 - August 1 - Wet and Wonderful

RATES
Weekly rate ................................$160
*Week 3.....................................$130
ADDITIONAL CAMPERS
Additional children (per week) ...... $135
Number addl campers:

BUS TRANSPORTATION
Bus Fee (per week, if applicable) .... $15
Number of bus riders

SCHOLARSHIP
Common Ground offers a select number of scholarships for campers who would not otherwise be able to attend Earth Camp. While we cannot guarantee that your child receive any weeks, please check as many as your child would like to attend. Applications must be received by June 1st. Deposits are not required for scholarship applicants.

Request a scholarship:




AMOUNT DUE
 
Subtotal for first camper
   $
 
Subtotal for add'l campers
   $
 
Subtotal for Bus Fee
  $
 
Total Due
   $
 
Deposit Required
   $
 
*Amount you would like to pay today
(must be at least as much as Deposit Required)
  $

PARENT/GUARDIAN INFORMATION
 
Parent/Guardian *First Name
 Parent/Guardian
*Last Name
*Relationship
 
*Address
 
*City
 *State
*Zip
 
*Country
 
*Email *Home Phone Work Cell

CAMPER INFORMATION
  Camper #1                      
 
*First
Name
  
*Last
Name
 
*Age
  *Date of Birth
 



 
Camper #2
   
     
 
First
Name
  
Last
Name
 
Age
  Date of Birth  

Male

 
Camper #3
   
     
 
First
Name
  
Last
Name
 
Age
  Date of Birth  
Male
 
Camper #4
   
     
 
First
Name
  
Last
Name
 
Age
  Date of Birth  
Male
 
Comments:
 
 

We use Paypal for processing contributions. Click the button below to enter your payment information. After your contribution has been processed a receipt will be sent to you via email. If you do not have an email address, please contact us if you want a receipt.

*A deposit of $75.00 per child is required with this registration, which will be credited your total camp fee. A $25.00 service charge is withheld for cancelled registrations. Balance of payment is due at least 5 days before your child or children starts camp. Earth Camp reserves the right not to accept registration if full payment is not made 5 days before starting. Please note that in the rare case of severe weather conditions such as floods, camp will be cancelled for safety reasons and no refunds or makeups will be provided.