| St. Vartan Camp Online Application
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| Please provide the information. After submitting this form, you will be directed to online payment using our secure server. You can register multiple campers for one session using the on-line system. If you are registering multiple campers for multiple sessions, you must register each seperatly. |
| Camper Information |
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First Camper: First Name* |
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First Camper: Last Name* |
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First Camper: Date of Birth (mm/dd/yy)* |
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First Camper: School Grade in Fall 2007* |
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First Camper: Camper E-Mail Address* |
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| First Camper: Gender* |
Boy
Girl |
| First Camper: T-shirt Size* |
S
M
L
XL
XXL |
I would like to room with:
Roomate requests should be made for campers in the same age group and will be honored when possible, but are not guaranteed. |
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| Add additional campers below or go directly to parent information. |
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Second Camper: First Name |
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Second Camper: Last Name |
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Second Camper: Date of Birth (mm/dd/yy) |
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Second Camper: School Grade in Fall 2007 |
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Second Camper: Camper E-Mail Address |
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| Second Camper: Gender |
Boy
Girl |
| Second Camper: T-shirt Size |
S
M
L
XL
XXL |
| I would like to room with: |
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Third Camper: First Name |
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Third Camper: Last Name |
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Third Camper: Date of Birth (mm/dd/yy) |
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Third Camper: School Grade in Fall 2007 |
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Third Camper: Camper E-Mail Address |
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| Third Camper: Gender |
Boy
Girl |
| Third Camper: T-shirt Size |
S
M
L
XL
XXL |
| I would like to room with: |
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| Parent Information |
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Mother's Name* |
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Father's Name* |
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Mother's Daytime/Work Telephone* |
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Mother's Cell Telephone* |
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Father's Daytime/Work Telephone* |
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Father's Cell Telephone* |
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Parent Evening (Home) Telephone* |
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Mother's E-Mail Address* |
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Father's E-Mail Address* |
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Parent Address* |
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Parent City* |
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Parent State and ZIP Code* |
State:
ZIP code:
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Parent Parish Affiliation |
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| Desired Session * |
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Session A
On-line registration for session A is now closed. However, there are limited spots still available based on gender and age. Please call Jennifer Morris at 212-686-0710 ext 118 to inquire.
Session B
Session B is full, please call Jennifer Morris at 212-686-0710 ext.118 to add your name to the waiting list.
Session C
Full Session C
Two-week session: July 20-August 02
Tuition: $880
Session C1
One-week session: July 20-26
Tuition: $480
Session C2
One-week session: July 27-August 02
Tuition: $480
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Are you willing to attend another session if your first choice is unavailable? |
Yes
No |
| Special notes or comments (please include name on credit card to be used if different from parents listed above):
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