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Sea Camp Registration

 

Registration Instructions

  1. Determine the camp in which you are interested and write down the Call #.
  2. Have ready all personal information listed below and call Lynette DeBerry at (757) 683-4247.
  3. Have payment information ready.  You will have the option of providing this over the phone, faxing the form below, or mailing the information (if paying by check).  Please understand that camper is not enrolled until payment is processed.

 

DATES Camp Type Call # Term
WK1: June 22-26 Jr. Camp 6-8 90064 200845
WK1: June 22-26 Jr. Camp 6-8 90065 200845
WK1: June 22-26 Sr. Camp 9-12 90066 200845
       
WK2: July 6-10 Jr. Camp 6-8 90004 200915
WK2: July 6-10 Sr. Camp 9-12 90014 200915
WK2: July 6-10 Sr. Camp 9-12 90015 200915
       
WK3:July 13-17 Jr. Camp 6-8 90005 200915
WK3:July 13-17 Sr. Camp 9-12 90016 200915
WK3:July 13-17 Teen Camp 13-17 90012 200915
       
WK4: July 20-24 Jr. Camp 6-8 90006 200915
WK4: July 20-24 Jr. Camp 6-8 90007 200915
WK4: July 20-24 Sr. Camp 9-12 90017 200915
       
WK5: July 27-31 Jr. Camp 6-8 90008 200915
WK5: July 27-31 Sr. Camp 9-12 90018 200915
WK5: July 27-31 Sr. Camp 9-12 90019 200915
       
WK6: August 3-7 Jr. Camp 6-8 90009 200915
WK6: August 3-7 Sr. Camp 9-12 90020 200915
WK6: August 3-7 Teen Camp 13-17 90013 200915
       
WK7: August 10-14 Jr. Camp 6-8 90010 200915
WK7: August 10-14 Jr. Camp 6-8 90011 200915
WK7: August 10-14 Sr. Camp 9-12 90021 200915
Child's Name:______________________________________
Birth Date (M/D/Y)_________________Gender:___________Age:____
Address:__________________________________________________
City:____________________________State:_____________Zip:____________
CHILD MUST be registered in the proper age group. No exceptions.
Parent/Guardian Name:________________________________
Day Phone:______________________
Evening Phone:______________________
Email address:_______________________________________________
Please check the appropriate line based on the number of children you are registering.
____I authorize the amount of $225 to be charged to my:
____I authorize the amount of $213.75 to be charged to my:
There is a 5% discount for siblings who register together
Please include your 3 digit Security code  and billing zip code for credit card authorization.
Visa     Mastercard     Check
Card No.____________________________________Exp. Date:____________ _____________ Exp. Date:___________
Security code:_________ Billing zip Code_______________
Authorizing signature:_______________________________________________