Registration Form 2014

Camp Home

Download the 2014 camp brochure (PDF)

Please fill out one form per child.

You may also make a payment on a previous registration.

Family Information
You are a
I first heard about Concord Academy Summer Camp from: (check all that apply)
Have any of your family members attended Concord Academy for School?
Parent/Guardian (1) Information
Parent/Guardian (2) Information
Emergency Contact (other than parent/guardian)
Camper
Gender
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
Week 1: June 23 - 27
Week 2: June 30 - July 3*
Week 3: July 7 - 11
Week 4: July 14 - 18
Week 5: July 21 - 25
Week 6: July 28 - August 1
Week 7: August 4 - 8
Week 8: August 11 - 15
Transportation Registration
Transportation needs

One-Way (AM or PM): $60/week | Round-Trip: $100/week

Bus Route 1:
Bus Route 2:
Financial Aid
I would like to make a tax-deductible donation of:
Billing Information
Payment Information
Payment Option
$0
/

Registration Agreement

My submission of this form certifies 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, 2014 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, 2014.
  • 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.

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.

During the camp season, staff members and/or professional photographers take photos for marketing purposes, which may include the child(ren) listed on this registration form. Parents/guardians may refuse any or all commercial use of these photos related to specific campers, provided that a written request is received by the camp director prior to the start of camp. Please include a current photograph of your child with the written request, so we can make certain their photo is not used for marketing purposes.

To make an additional payment, or to pay the balance, please visit the Payment Page