Please fill out all applicable information       (*required field)

  
  Home Phone Number *          
                   
  Parent Tot Information            
                   
  Camper                
  Last Name*     First Name * Date of Birth*
  T-Shirt  Size   Gender Age
  Parent Attending   Sibling Enrolled Yes No    

 

 

  Session Information        
  Tuesdays (6/26-8/7) Lunch Bunch Yes  No    
  Wednesdays (6/27-8/8)        

 

 

 

 

  Family Information        
  Mother Name Father Name    
  Mother Cell Father Cell    
  Email Address    

 

 
  Payment Options*    
  Parent Tot  - $250.00 before 3/31, $300 after 3/31        
              Lunch Bunch - $70.00        

   

  Credit Card Information *     
  Name (as appears on card)*   Phone*          
  Street Address*   City*   State* Zip Code*  
 

Card Type

  

Account Number*

          
 

Exp. Date*

  

CVV2/CVC2 (security #)*

          
                   
 

Terms and conditions

I understand that part of the camping experience involves activities and group interactions, and come with uncertainties beyond what my child may be used to dealing with. I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk-free, and so I have instructed my child on the importance of abiding by the camp’s rules, and my child and I both agree that he or she is familiar with these rules and will obey them.

I further agree to allow my child to be used in any promotional photography (newsletter, brochure, video, web site, etc.).

 

I agree that any dispute concerning, relating, or referring to this contract, any representation concerning my child’s camping experience, or the camping experience itself shall be resolved exclusively by binding arbitration in Lake County, Illinois, according to the then existing commercial rules of the American Arbitration Association and the substantive laws of that state.
                 
    I agree to the above terms and conditions *        
      
                 
 
             

 
       

 

  
 
 
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