Application | Camp Birch Knoll

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camp birch knoll

2022 Application for Enrollment

Select a session

July 17 - July 30 (2 Weeks)

July 17 - August 10 (4 Weeks)

Camper First Name

Camper Last Name

Grade

Birthday

Age

Camper Email

Street Address

Street Address Line 2

City

State

Zip Code

Country

This will be my camper's

year at camp

Does your camper live with both parents?

Yes

No

If No

Separated/Divorced

Mother Deceased

Father Deceased

Other

Mother Name

Mother Email

Mother Phone

Mother Address

Mother Occupation

Friend Request

Transportation

Bus to Camp ($200)

Bus from Camp ($200)

Round trip Bus ($350)

We will drop off and pick up

Other

Camp Policy and Fee Information

Father Name

Father Email

Father Phone

Father Address

Father Occupation

Emergency Contact Name

Emergency Contact Phone

Visitor's Weekend Transportation July 15-17 for 8 Week Campers

We will pick up and drop off

Round trip Bus ($100)

CBK Policy 2022.pdf

I have read the Camp Policy and Fee Information, and agree to payment of all applicable fees and agree to adhere to all of the camp policies.

Your Signature

Thank you!

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