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For pre-teenagers 8-12, teenagers 13-17, and young women 18-21

2010 Dates

Select Session
Session: Rates
8 Weeks 6/23-8/14 $7790
4 Weeks 6/23-7/18 $4550
3 Weeks 6/23-7/11 $3750
YEAR END SPECIALS  
4 Weeks 7/18-8/14 $3600
3 Weeks 7/25-8/14 $2550
2 Weeks 7/31-8/14 $1700
Parent Program Call

Rates for Additional Weeks
$900 for 2 & 3 Week Campers |  $800 for 4 Week Campers

Holdover Rates:

$900.00 per week for 2 & 3 week campers
$800.00 per week for 4 week campers

Camper Information
Camper’s Name:
Date of Birth (MM/DD/YY):
Age:
Grade (Next Sept):
Name of School:
Home Address:
City:
State and/or Country:
Zip or Postal Code:
Home Phone:
Business Phone (father):
Business Phone (mother):
Email Address:

Father's Work Info
Father's Firm Name:
Address:
City:
State and/or Country:
Zip or Postal Code:

Other Parent/Guardian Work Info
Parent/Guardian Firm Name:
Address:
City:
State and/or Country:
Zip or Postal Code:

How did you hear about us? (name of friend, newspaper, magazine, or referal agency) If you found us through a magazine or newspaper please specify which one.

Deposit of $500 is payable upon submission of this agreement. Payable in US funds. Balance is payable on or before May 15th. Deposits refunded in full up to June 1st upon receipt of written notification. Please make check payable to Camp Pennbrook.

The camping period set forth above includes room and board, general camping program, medical and nutritional staff. Parents, relatives, and campers agree to abide by the rules and regulations promulgated by the camp directors and staff for safety, health and well being of the camp. There will be no allowance or refunds made in the event of a late arrival or early departure. Conduct inimical to the best interest of the camp will result in discharge without benefit of refund. The camp retains the right to use for publicity purposes any photographs, likenesses, statements or letters of any enrolled camper for use in any media. The camp is not responsible for loss of any personal property, i.e. clothing, radios, cameras, walkman, etc. Parent or guardian are responsible for any incidental charges incurred by campers, i.e. special prescriptions, medical or dental charges, special off campus trips, or personal shopping needs.

The above agreement constitutes the entire understanding between the parties.

Medical Information
Major Medical Carrier:
Policy Number:

If you wish any portion of the tuition charged, please complete the following.

Credit Card Info
Method of Payment:
Card #:
Expiration Date:
Amount to be charged:
Name as it appears on card:
Address:
City:
State and/or Country:
Zip or Postal Code:

By Clicking the Submit Button you are in essence providing your signature.