FREE Information For Teen Travel
and Summer Programs
Fields marked with an asterisk (*) are required.
Teen’s First Name: *
Teen’s Last Name: *
Gender: *
Male
Female
Date of Birth: *
Age: *
Current Grade: *
School Attending: *
Grade Next September: *
Previous Camp Experience:
Interested in programs for: *
Summer 2010
Summer 2011
Summer 2012
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
Google
Facebook
Search Engine
Community Paper
Word of Mouth
I'm a Previous Client
Other
Please Specify:
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
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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