Teen Tours and Summer Programs
Fields marked with an asterisk (*) are required.
Mother’s First/Last Name: *
Father’s First/Last Name: *
Address: *
City: *
State/Country: *
Zip Code: *
Home Phone: *
Work Phone:
Cell Phone:
Email: *
Who is completing this form? *
Mother
Father
Student
ABOUT MY TEEN
(please complete a separate form for each teenager)
Teen’s First Name: *
Teen’s Last Name: *
Gender: *
Male
Female
Date of Birth: *
Age: *
Current Grade: *
School:
Grade Next September: *
Previous Camp Experience:
Interested in programs for: *
Summer 2008
Summer 2009
Number of Weeks:
Indicate any special interest:
Range Per Week: *
above $800
above $1000
above $1200
Check all that apply OR let us know your needs in the space provided below.
Pre-College Program:
Yes
No
Location:
United States
Europe
Worldwide
Teen Travel:
Yes
No
Destination:
United States
Europe
Worldwide
Length of trip:
Select
Weekdays only
3 weeks
4 weeks
5 weeks
6 weeks
Community Service:
Yes
No
Location:
United States
Europe
Worldwide
Study Abroad:
Yes
No
Indicate Country:
Language Immersion:
Yes
No
Indicate Language:
Internships:
Yes
No
Location:
United States
London
Remedial Programs:
Yes
No
Academic Enrichment:
Yes
No
Specialty Sports Camps:
Yes
No
Indicate Sport(s):
Distance from home:
2-3 hrs.
4 or more hrs.
Distance not a factor
Outdoor Adventure Programs:
Yes
No
Select type:
Select
Biking
Hiking
Rafting
Sailing
Rock Climbing
All
Other
Distance from home:
2-3 hrs.
4 or more hrs.
Distance not a factor
Please provide any additional info that would be helpful:
How did you find us?
Select
Search Engine
Community Paper
Word of Mouth
I'm a Previous Client
Other
Please Specify:
If you would like to complete the form for another child, please press submit and you will then be prompted to complete the necessary fields for the next child.
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