| Mother's First and Last Name |
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| Mother's Address |
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| City |
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| State |
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| Zip Code |
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| Mother's Home Phone |
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| Mother's Work Phone |
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Mother's Cell Phone |
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| Mother's E-mail |
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| Father's First and Last Name |
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| Father's Address |
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| City |
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| State |
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| Zip Code |
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| Father's Home Phone |
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| Father's Work Phone |
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Father's Cell Phone |
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| Father's E-mail |
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How did you hear about Crystal Lake Camps? |
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| Please send me information on applying for financial aid. |
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| Initial Deposit -- Number of Children x $150 = |
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| Note: After you submit this form, you will automatically be directed to a page with information about making a deposit. |
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Child 1 |
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| First Name |
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Last Name |
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| Male |
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| Female |
| Birthdate |
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Current Grade |
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| Sessions |
I
II III
IIIa (1-week option) |
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Special Programs - Check all that apply |
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Horseback Riding (Sessions 1,2 and 3) |
Hands-on Horsemanship (Session 2 only) |
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Counselor in Training (Sessions 1, 2 & 3 - 6 weeks) |
Leadership Training (Sessions 1 & 2) |
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Lifeguarding (Session 3 only) |
Trailblazers (Sessions 1, 2 & 3) |
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| Project Worker (All Sessions) |
Eagle Rock Adventure (Sessions 2 & 3) |
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Child 2 |
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| First Name |
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Last Name |
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| Male |
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| Female |
| Birthdate |
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Current Grade |
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| Sessions |
I
II III
IIIa |
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Special Programs - Check all that apply |
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Horseback Riding (Sessions 1,2 and 3) |
Hands-on Horsemanship (Session 2 only) |
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Counselor in Training (Sessions 1, 2 & 3 - 6 weeks) |
Leadership Training(Sessions 1 & 2) |
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| Lifeguarding (Session 4) |
Trailblazers (Sessions 1, 2 & 3) |
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| Project Worker (All Sessions) |
Eagle Rock Adventure (Sessions 2 & 3) |
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Child 3 |
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| First Name |
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Last Name |
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| Male |
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| Female |
| Birthdate |
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Current Grade |
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| Sessions |
I (1-week session)II III
IIIa |
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Special Programs - Check all that apply |
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Horseback Riding (Sessions 1,2 and 3) |
Hands-on Horsemanship (Session 2 only) |
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Counselor in Training(Sessions 1, 2 & 3 - 6 weeks) |
Leadership Training(Sessions 1 & 2) |
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| Lifeguarding (Session 4) |
Trailblazers(Sessions 1, 2 & 3) |
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| Project Worker (All Sessions) |
Eagle Rock Adventure (Sessions 2 & 3) |
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I hereby apply for admission of my child to Crystal Lake Camps. I will make a deposit of
which I understand will be applied to the camp fee and is not returnable unless cancellation is received prior to March 1. I agree to pay the balance of the camp fee, riding fee, and incidentals deposit on or before May 1. I understand that if unenrollment occurs within 4 weeks of the start of the camp session, camp fees will not be refunded but can be applied to the following summer.
I understand that since counselors are engaged and other arrangements are made by the camps for the entire season in advance, the camp fee is not subject to return or reduction for late arrival or early departure, whether due to withdrawal or dismissal. The director reserves the right to require withdrawal of any camper if deemed for the best interest of the camp.
Signature:
Date:
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