Camp St. Andrew
 2008 Registration Form  

Please print this form, fill it out and return it with your payment to:                   

          Camp St. Andrew
           524 Stark Rd.
          Tunkhannock , PA 18657  

Office Use Only

Amount Rec'd $______________

Balance Due $___________

Cabin#___________

______L _____E

______A

PLEASE CHECK THE APPROPRIATE SPACE

____July 6 - 11 Girls Basketball
       (entering grades 5-10)

____July 6 - 11 Girls Traditional Residential Camp (entering grades 3-9)

____July 13 - 18 Girls Basketball
       (entering grades 5-10)

____July 13 - 18 Girls Traditional Residential  Camp (entering grades 3-9)

____July 18 - 20 Father/Son Weekend
       (sons ages 6-13)

____July 20 - 24 Boys Basketball
       (entering grades 4-9)

PLEASE PRINT CLEARLY
Camper's Last Name_______________________

First Name_______________    M.I.____

Male____      Female____

Address_____________________________________

City_______________State_____Zip__________

Age______  Date of Birth______________ Grade as of 9/08_______

School:___________________________________________

Email:_____________________________

Home Phone(      )_______________

Mother's Name_______________________
Work Phone(      )___________      Cell(      )___________

Father's Name_______________________

Work Phone(      )___________      Cell(      )____________

How did you hear about Camp St. Andrew?________________________________________

____________________________________________________________________________

I would like to be assigned a cabin with the following camper(s):
_____________________________________________________________________________

_____________________________________________________________________________

T-shirt size (please circle one) Youth:  S  M  L         Adult:  S  M  L  XL

A deposit of $100 is required with application. Balance due on the day of registration at Camp.

Make checks payable to: Camp St. Andrew  
                

Amount enclosed: ________________    Check#___________________


In submitting this application, I hereby accept the care and direction of Monsignor Kelly and the staff of Camp St. Andrew. Camp has my permission to use any photographs taken of my children in its annual Camp promotion. I approve this application and certify that our child is in good health. Acceptance of this application is contingent upon the camper passing a physical examination within one year before attending Camp.  


Signature of Parent/Guardian_______________________________ Date____________