Information Request Form

Session 1	June 24 thru July 6
Session 2	July 8 thru July 20
Session 3	July 22 thru August 3

Tuition per Session: 1, 2 or 3: $2790
An additional session is $2590.
For a camper attending all three sessions the third session is $2390.

There is a one time $100 sibling discount for 2nd child
$500 Deposit per session
Greens Fees are $95 per week additional

Tuition includes room & board, on-campus activities, local off campus trips (i.e. bowling, movies, etc.), laundry, evening & bedtime snacks, etc. "Between Session Stayover" is $195.

Please Fill Out & Complete All Fields
Note: Use "TAB" Key and/or Pointer to Move Between Fields

PROSPECTIVE CAMPERS

Please fill out the following information to receive:

Additional Promotional Materials
Parent's Name:
Address:
City:
State and/or Country:
Zip or Postal Code:
Home Phone:
Work Phone:
Cell Phone:
Email Address:

Camper Information
1st Camper's Name:
Date of Birth:
Grade as of 09/12:

1st Camper's Name:
Date of Birth:
Grade as of 09/12:

1st Camper's Name:
Date of Birth:
Grade as of 09/12:

How did you hear about us?

Comments to Joel: