Grier Summer Programs 2010 Registration Form

Camper Information

Name:

Age at camp:

Date of Birth:

Current grade in school:

Address:

City:

State:

Zip code:

Country (if not US):

Camper email address:

Camper phone number:

Camp Sessions and Fees

 Other fees - regular sessions only:

Incidentals Fee: Campers age 7-15: $50 per session

Teen Outings & Incidental Fees: Campers age 16-17: $150 per session

These fees are due June 1

Parent Information

Mother's name:

Address:                                                                                                                       (if different from camper)

City:

State:

Zip Code:

Home Phone:

Work Phone:

Cell Phone:

Mom's Email:

Father's name:

Address:                                                                                                                       (if different from camper)

City:

State:

Zip Code:

Home Phone:

Work Phone:

Cell Phone:

Dad's Email:

Camper lives with:

If other, note relationship:

Send billing to:

If other, provide name & address:

Pen Pal List

Check Yes or No:

Roommate Request:  Grier Summer Program will accommodate a roommate request if the request is mutual and the campers are the same age.

Roommate:

Transportation to Camp

Grier Summer will provide transportation for campers from and to local airports in State College and Altoona, and from and to local Amtrak stations in Altoona and Tyrone.  During specified times on designated arrival and departure days, we can also provide transportation from and to the Pittsburgh International Airport and Dulles Washington International Airport.  Please contact the camp director before booking flights.  There is a fee for transportation to major airports.

Traveling to camp:

Traveling from camp:

Emergency Contact Information (other than parents)

Name:

Relationship:

Phone number(s):

Name:

Relationship:

Phone number(s):

A $500 deposit is required with your registration ($100 for Mother – Daughter sessions only).

The balance of the camp fee is due June 1.  If you cancel a camp session after May 1, we will not refund your deposit.

PLEASE MAKE CHECK PAYABLE TO "GRIER SUMMER"

I understand that Grier Summer does not issue refunds if a camper goes home early due to homesickness or unwillingness to follow rules.

Parent Initials:

How did you find out about Grier Summer Programs/Allegheny Riding Camp?

Which Internet site?

Referral Service:

Thank you for submitting your registration form online!

For validation of your registration, please print two (2) copies of the PDF form. Sign one copy and mail it into the office with your fee and keep one copy for your records.

If you have any quesitons, please contact Helen Zientek, Camp Director