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Please Complete One Form Per Camper
Camper's First Name:
Camper's Last Name:
Camper's Grade:
(Fall 2024)
Gender:
Male
Female
Birthdate:
-
-
(mm-dd-yyyy)
Shirt Size:
Youth:
Small
Medium
Large
X-Large
How did you hear about us?
Address:
City:
State:
Zip:
Phone:
Parent 1 Name:
Parent 1 Cell Phone:
Parent 1 Email:
Parent 2 Name:
Parent 2 Cell Phone:
Parent 2 Email:
Please provide us with any additional information that you
would like our staff to know about your child
(dietary needs, food allergies, etc.):
Dates:
Saturday, July 27th • 11:00 am
to Sunday, July 28th • 4:00 pm
Fee:
$250
of which $150 will be credited for all campers
that enroll for the 2025 camping season.
Price includes bus transportation to/from camp.
Transportation:
To Camp
July 27th
Please select:
Long Island Bus
Westchester Bus
Livingston Bus
I will drive my child to Discovery Camp
From Camp
July 28th
Please select:
Long Island Bus
Westchester Bus
Livingston Bus
I will pick my child up from Discovery Camp
Enter Billing Information
TOTAL AMOUNT DUE:
$250.00
Payment Method:
Visa/MasterCard
eCheck
Charge my:
MC
Visa
*
There will be a 3% convenience subcharge if paying by MasterCard.
First Name on Card:
Last Name on Card:
Card #:
Exp. Date:
Month...
01
02
03
04
05
06
07
08
09
10
11
12
Year...
20
21
22
23
24
25
26
27
28
29
30
Routing Number:
Account Number:
Billing Street Address:
Billing City:
Billing State:
Billing Zip:
Any Questions?
Please call the camp office at 516-781-5200, or email
Kylie
or
Marc
.