NorthBay Summer Center Registration High School
Parents,
Please fill out each section and submit this information for acceptance. Deposit is required to secure registration.
Email address *
Student's First Name *
Your answer
Student's Middle Initial
Your answer
Student's Last Name *
Your answer
Student's Gender *
Grade student will be entering (Fall 2020) *
Your answer
Students Date of Birth (MM/DD/YYYY) *
Your answer
Student's Age (as of June 1, 2020) *
Your answer
Student's Street Address / P.O. Box Number
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
School District
Your answer
Current School
Your answer
Top 2 Track Choices *
Your answer
T-Shirt Size (unisex adult) *
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Telephone Number *
Your answer
Are you interested in NorthBay’s Counselor-in-Training Program ?
This is a NorthBay Summer Camp experience with an added leadership training opportunity for 11th and 12th graders. Must submit “kids” resume and cover letter highlighting the attributes that you would bring to camp. Please send to summercenter@northbayadventure.org
Are you interested in carpooling? *
If so, we can connect you (via email) with other families in your area that will be attending.
Do you need financial assistance? *
Scholarship allocation decisions will be determined by April 24th
A $125 non-refundable deposit is required to secure your spot
Checks can be made out to NorthBay Education, Inc. and mailed to 11 Horseshoe Point Ln. North East MD, 21901. Credit card transactions have a 3% fee & can be completed through this form or over the phone at 443-967-0500. A receipt will be emailed to the attached email address.
Payment Options
Full name on Card
Your answer
Card Number
no spaces or dashes
Your answer
Expiration Date
Your answer
Security code
The three digit code on the back of the card (4 digit code on the front of American Express cards)
Your answer
Billing Address
Your answer
Amount Approved
Please write in the amount you would like to pay in full at this time
Your answer
Please download and complete the Health and Medication Authorization forms located in the drop down menu below.
Please send forms, any other information you would like to share, or questions you have to summercenter@northbayadventure.org or call 443-674-9034.
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This form was created inside of NorthBay Adventure.