APPLICATION FOR ENROLLMENT
(Please complete, print, sign and return by mail -- signature required)

I wish to enroll my son for Wachusett's 2012 season and enclose a check in the amount of $800 -- or $400 for a one-week enrollment -- to cover the registration fee.  I understand that the entire fee will be deducted from the total tuition and that the full amount will be refunded if notification of a change in plans is received before May 1, 2012 -- with half the fee refunded after the 1st of May.

Boy's name:

Parents' name:

Street:

City:    State:     Zip:

E-mail address:  

Date of Birth:    Home Phone: 

Name of School    Current Grade

When I complete the Health Record in the spring of 2012, I will inform you of any facts important in safeguarding my son's physical welfare.  I agree to whatever rules and regulations are laid down for the general welfare.

Please check the appropriate enrollment option:

One-week session (July 24 -- July 30)
One-week session (July 1 -- July 7)
One-week session (July 15 -- July 21)
One-week session (July 29 -- August 4)
Two-week session (June 24 -- July 7)
Two-week session (July 1 -- July 14)
Two-week session (July 15 -- July 28)
Two-week session (July 29 -- August 11)
Three-week session (July 1 -- July 21)
Three-week session (July 15 -- August 4)
Three-week session (July 24 -- July 21)
Four-week session (July 1 -- July 28)
Four-week session (July 15 -- August 11)
Four-week session (June 24 -- July 28)
Five-week session (July 1 -- August 4)
Five-week session (June 24 -- August 4)
Six-week session (July 1 -- August 11)
Full seven-week season (June 24 -- August 11)


____________________            ___________________________________
DATE                                                                     PARENT OR GUARDIAN

 

Please print and mail to:

CAMP WACHUSETT CO. 
James Weiss
11112 Waycross Way
Kensington, MD  20895
PHONE NUMBERS:
(301) 933-1709
1-800-847-9763
FAX NUMBER: (301) 933-0453


If you know of any family that might have an interest in Wachusett, we would appreciate your help in providing us with the name and address.  We then will send information about the 2012 season to the family.

Boy's name:

Parents' name:

Street:

City:   State:    Zip:

E-mail address (if known):  

Please print and return
(signature required)


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Camp Wachusett, 1430 Camp Road Hubbardton, Brandon, VT  05733