Corey Testing

Alumni Camp Registration

Date*

MM slash DD slash YYYY
Number of Adults (11 years and older) in your Family Group Spending the weekend and sleeping at camp*
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
A $100 registration fee per person will be charged at the end of this form.
Full Weekend Adult Name 1:*

First

Last
Full Weekend Adult Name 2:*

First

Last
Full Weekend Adult Name 3:*

First

Last
Full Weekend Adult Name 4:*

First

Last
Full Weekend Adult Name 5:*

First

Last
Full Weekend Adult Name 6:*

First

Last
Full Weekend Adult Name 7:*

First

Last
Full Weekend Adult Name 8:*

First

Last
Number of Adults (11 years and older) in your Family Group Coming for Day Camp*
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
A $50 fee per person will be charged at the end of this form.
Day Camper Adult Name 1:*

First

Last
Day - a $50 deposit will be charged now and the remainder will be billed*
- Saturday - $50
- Sunday - $50
- Saturday & Sunday - $100
- All days - $130
Day Camper Adult Name 2:*

First

Last
Day - a $48 deposit will be charged now and the remainder will be billed*
- Saturday - $48
- Sunday - $48
- Saturday & Sunday - $96
- All days - $120
Day Camper Adult Name 3:*

First

Last
Day - a $48 deposit will be charged now and the remainder will be billed*
- Saturday - $48
- Sunday - $48
- Saturday & Sunday - $96
- All days - $120
Day Camper Adult Name 4:*

First

Last
Day - a $48 deposit will be charged now and the remainder will be billed*
- Saturday - $48
- Sunday - $48
- Saturday & Sunday - $96
- All days - $120
Day Camper Adult Name 5:*

First

Last
Day - a $48 deposit will be charged now and the remainder will be billed*
- Saturday - $48
- Sunday - $48
- Saturday & Sunday - $96
- All days - $120
Day Camper Adult Name 6:*

First

Last
Day - a $48 deposit will be charged now and the remainder will be billed*
- Saturday - $48
- Sunday - $48
- Saturday & Sunday - $96
- All days - $120
Day Camper Adult Name 7:*

First

Last
Day - a $48 deposit will be charged now and the remainder will be billed*
- Saturday - $48
- Sunday - $48
- Saturday & Sunday - $96
- All days - $120
Day Camper Adult Name 8:*

First

Last
Day*
- Saturday
- Sunday
Number of Children (age 4 to 10) in your Family Group Spending the Weekend and sleeping at camp:*
- None
- 1
- 2
- 3
- 4
- 5
A $100 registration fee per person will be charged at the end of this form.
Full Weekend Child Name 1:*

First

Last
Child 1 Date of Birth:*

MM slash DD slash YYYY
Child 1 Gender:*
- Male
- Female
Full Weekend Child Name 2:*

First

Last
Child 2 Date of Birth:*

MM slash DD slash YYYY
Child 2 Gender:*
- Male
- Female
Full Weekend Child Name 3:*

First

Last
Child 3 Date of Birth:*

MM slash DD slash YYYY
Child 3 Gender:*
- Male
- Female
Full Weekend Child Name 4:*

First

Last
Child 4 Date of Birth:*

MM slash DD slash YYYY
Child 4 Gender:*
- Male
- Female
Full Weekend Child Name 5:*

First

Last
Child 5 Date of Birth:*

MM slash DD slash YYYY
Child 5 Gender:*
- Male
- Female
Number of Children (age 4 to 10) in your Family Group Coming for Day Camp:*
- None
- 1
- 2
- 3
- 4
- 5
A $25 registration fee per person will be charged at the end of this form.
Day Camper Child Name 1:*

First

Last
Day - a $25 deposit will be charged now and the remainder will be billed*
- Saturday - $25
- Sunday - $25
- Saturday & Sunday - $50
Child 1 Date of Birth:*

MM slash DD slash YYYY
Child 1 Gender:*
- Male
- Female
Day Camper Child Name 2:*

First

Last
Day - a $25 deposit will be charged now and the remainder will be billed*
- Saturday - $25
- Sunday - $25
- Saturday & Sunday - $50
Child 2 Date of Birth:*

MM slash DD slash YYYY
Child 2 Gender:*
- Male
- Female
Day Camper Child Name 3:*

First

Last
Day - a $25 deposit will be charged now and the remainder will be billed*
- Saturday - $25
- Sunday - $25
- Saturday & Sunday - $50
Child 3 Date of Birth:*

MM slash DD slash YYYY
Child 3 Gender:*
- Male
- Female
Day Camper Child Name 4:*

First

Last
Day - a $25 deposit will be charged now and the remainder will be billed*
- Saturday - $25
- Sunday - $25
- Saturday & Sunday - $50
Child 4 Gender:*
- Male
- Female
Child 4 Date of Birth:*

MM slash DD slash YYYY
Day Camper Child Name 5:*

First

Last
Day - a $25 deposit will be charged now and the remainder will be billed*
- Saturday - $25
- Sunday - $25
- Saturday & Sunday - $50
Child 5 Gender:*
- Male
- Female
Child 5 Date of Birth:*

MM slash DD slash YYYY
Child 5 Gender:*
- Male
- Female
Number of Children (age 3 or under) in your Family Group:*
- None
- 1
- 2
- 3
Child Name 1:*

First

Last
Child 1 Date of Birth:*

MM slash DD slash YYYY
Child 1 Gender:*
- Male
- Female
Child Name 2:*

First

Last
Child 2 Date of Birth:*

MM slash DD slash YYYY
Child 2 Gender:*
- Male
- Female
Child Name 3:*

First

Last
Child 3 Date of Birth:*

MM slash DD slash YYYY
Child 3 Gender:*
- Male
- Female
How would you like your mail addressed?*
Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Email*
Best number to call you if we have a question:*
How do you know about camp?
Our housing options are available on a first-come, first-served basis. Please let us know your top 2 choices so we may accommodate you if your first choice is not available. Thank you!
What is your first housing choice? (If your choice isn't available, it is waitlisted, please call the office)
- Deer Run Lodge (Queen Bed private bathroom)
- Deer Run Cabin Backroom (Queen bed, bunk bed, private bathroom)
- Brookwoods Cabin Backroom (3 bunkbeds with cold water only)
- Brookwoods Cabin (excluding Ranger) (6 bunkbeds with cold water only)
Cabin Preference
Anything else we need to know?:
Would you like to send information about camp to a friend?*
- Yes
- No
We would be happy to send a New Information Package about camp to your child's friends.
Name (of the camper you are referring)

First

Last
Parent's Name

First

Last
Phone
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Hidden

Adult Registration Fee
Hidden

Adult Registration Fee Single Day
Hidden

Children (age 4 and up) Registration Fee
Total to be charged:
$0.00
If successfully submitted, you will receive an e-mail confirmation your credit card has been charged AND you will be directed to a "Confirmation Page" on the camp website. If that does not happen, please check your entry for some missing required information before hitting SUBMIT again.
Credit Card

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date

Security Code

Cardholder Name
Address (Much match credit card address)

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Name

This field is for validation purposes and should be left unchanged.