Please fill out one form per child - if you have multiple children, please complete and submit the first child, then press your browers "back" button and change the campers information.
We are a... New Family Returning Family
Name
Home Phone
Work Phone
Cell Phone
Email
Address
City
State
Address (if different)
I first heard about Concord Academy Summer Camp from: Friend Web Site Camp Fair Newspaper Internet Search Other
Have any of your family members attended Concord Academy for School? Yes (Name: ) No
Emergency Contact (other than parent/guardian)
Relationship to Camper
First Name
Last Name
Boy Girl
Date of Birth
Entering Grade (Sept. 2012)
T-Shirt Size
Child SM Child M Child L Adult S Adult M Adult L Adult XL
Friendship Request(s)
Transportation
Names of people (other than GUARDIANS listed above) authorized to pick up my child(ren)
It is OK to share my name and phone number for carpooling purposes:
Yes No
Week 1 June 25 - 29
Week 2 July 2 - 6*
Week 3 July 9 - 13
TEEN ADVENTURE CAMP
$1600 Air and Sea Adventures
$725 Community Service
$280 Half-Day Writing
$640 Music Technology Level 1
* There will be no camp on Wednesday, July 4, 2012. All one week camps have been pro-rated.
Please send in a check for $50 per camper per week, plus all transportation fees, to: Concord Academy Summer Camp 166 Main Street Concord, MA 01742. The balance is due and payable on or before May 1, 2012. Payment in full must accompany applications filed after May 1, 2012.
Registration Agreement: By clicking below, I certify that I have read, understand, and agree to all Registration and Cancellation/Change Policies.
I understand that the balance is due on or before May 1, 2012 and if balance is not paid, camper’s registration will be canceled.
I understand my child may not attend camp unless my child’s physician and I complete a Health Form prior to June 1, 2012.
I understand that the Camp Director has the right to dismiss a camper, when in their judgment the camper’s behavior interferes with the safety or rights of others, the group, or the rules of conduct established by Concord Academy Summer Camp.
I give my son/daughter permission to engage in all Concord Academy Summer Camp programs, activities, and events, including off-site trips by CA or commercial transportation. I understand there is NO CAMP on Wednesday, July 4, 2012.
All Concord Academy Summer Camp programs, as well as transportation routes, have a minimum enrollment requirement. Concord Academy Summer Camp reserves the right to cancel any program due to low enrollment.
To download CASC's Health Form and additional Forms, please click on "Parents Page"
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