camp echo bay, recreational camp

R E G I S T R A T I O N

CAMPER INFORMATION

First Name:

Last Name:

Female Male

Date of Birth:

Age:

Grade child will enter in September:

PARENT INFORMATION

First Name:

Last Name:

Address 1:

Address 2:

City:

State:

Zip:

Home Phone:	Business Phone:
Cell Phone:	Email:

Medical form mailed?	Yes No Download form here (PDF)
Do You Need Transportation?	Yes No
Transportation Stop (nearest corner)
Do you need Extended Care?	Yes No

June 30-July 4		July 7-11		July 14-18		July 21-25
July 28-August 1		August 4-8		August 11-15

	COST	#WEEKS	TOTAL
NON-Refundable Registration Fee	$100.00 X	n/a	$100.00
Camp Tuition	$275.00 X		$
Transportation	$100.00 X		$
A.M Extended Care	$70.00 X		$
P.M Extended Care	$70.00 X		$

		Total Due:	$

IMPORTANT INFORMATION

You must pay a minimum of the $100.00 NON-refundable registration fee at this time but can pay any portion
of your total due. Tuition and fees are non-refundable.
Any outstanding payment must be paid online or by check no later than one week in advance of attendance.

If printing and mailing this form, please fill out and mail with a check to:
CAMP ECHO BAY, Salesian High School, 148 Main Street, New Rochelle, NY 10801-5396

For further information, please call the Camp Director,
9:00 A.M. to 4:00 P.M. at (914) 632-0248 or (914) 576-1251 or email: campdirector@campechobay.org

SURVEY: TELL US ABOUT YOUR CHILD
What school is your child presently attending?

PAYMENT OPTIONS

Amount to pay: $