Teen Summer Programs

 

Fields marked with an asterisk (*) are required.

Mother’s First/Last Name: *
Father’s First/Last Name: *
Address: *
City: *
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Zip Code: *
Home Phone: *
Work Phone:
Cell Phone:
Email: *
Who is completing this form? *
 
ABOUT MY TEEN (please complete a separate form for each teenager)
 
Teen’s First Name: *
Teen’s Last Name: *
Gender: *
Date of Birth: *
Age: *
Current Grade: *
School:
Grade Next September: *
Previous Camp Experience:
Interested in programs for: *
Number of Weeks:
Indicate any special interest:
 
Range Per Week: *
Check all that apply OR let us know your needs in the space provided below.
 
Pre-College Program:
Location:
Teen Travel:
Destination:
Length of trip:
Community Service:
Location:
Study Abroad:
Indicate Country:
Language Immersion:
Indicate Language:
Internships:
Location:
Remedial Programs:
Academic Enrichment:
Specialty Sports Camps:
Indicate Sport(s):
Distance from home:
Outdoor Adventure Programs:
Select type:
Distance from home:
Please provide any additional info that would be helpful:
How did you find us?
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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