2017 Summer Camp Application
Summer @ St. Columba's Camp
Join us for 3 sessions (2 weeks each a total of 6 weeks) of fun at our 2017 Summer Camp. Join us in exploration of our Fun in the Sun. Each session will have a different focus related to outdoor play in the lazy days of summer.

To enroll, your child must be 36 months by June 19th, 2017. Due to the presence of water and pool play, YOUR CHILD MUST BE POTTY TRAINED.

The enrollment options are as follows:

3 (2 week) sessions from June 19 - July 28, 2017
9:00 am - 3:00 pm for 36 months to 8 years old.
Cost per session is $750. There is a discount for signing up for all 3 sessions of $1,920.00 (or $620 per

Session Options
*please indicate which sessions your child will attend/check all that apply
Is your child applying to be a Counselor in Training (CIT, 12-14 years old)? If yes, they must be available for 4 weeks of camp. They may choose Sessions 1 & 2 or 2 & 3. Cost is $200/session. Please indicate the sessions your child is available. Please note that preference for future paid positions is given to candidates who have completed our CIT program.
Child's Name:
*Please indicate what your child would like to be called as well.
Your answer
Parent/Guardian Name(s):
Your answer
Home Phone:
Your answer
Cell Phone:
Your answer
Street Address:
Your answer
City, State
Your answer
Zip Code
Your answer
Email Address
*Please list the emails you would like us to use for camp correspondence (if there are multiple, please separate by a comma)
Your answer
Child's birthdate:
Your answer
Child's Age (as of June 13):
Child must be 3 years old by June 13th, 2017.
Your answer
Current School:
Your answer
School attending in the fall:
Your answer
Grade level in fall:
Your answer
Any additional comment:
*Please list any special needs, allergies, or friends with whom you would like your child to be placed.
Your answer
Please indicate whether this applicant:
Never submit passwords through Google Forms.
This form was created inside of St. Columba's Episcopal Church. Report Abuse - Terms of Service - Additional Terms