Tanglewood Summer Camp Registration Form

UNIVERSITY OF MAINE COOPERATIVE EXTENSION

tanglewood 4-h camp

and learning center

Summer Camp Registration Form
Summer Camp Programs | Financial Aid | Sessions | Availability

Registration begins on January 1, 2008

To register for summer camp, complete this online form and mail your payment to: Tanglewood 4-H & Learning Center, One Tanglewood Road, Lincolnville, ME 04849. Please remember that your deposit is what guarantees you a camp slot.

Camper's First Name
Camper's Last Name
Camper's Gender	Male Female
Birth Date (mm,dd,yyyy)
Grade completed by June 2008
Parent/Guardian Name
Mailing Address
City
State
Postal Code
Country (if applicable)
County
Home phone
Work phone
Cell phone
Email
I would like to register for sessions
Please list sessions numbers in order of preference (see Sessions & Fees schedule for correct session number). 1st 2nd 3rd 4th
Please choose your Tanglewood Focus Plus Option ($50 extra).
Each camper may request one cabin mate (of similar age). If you would like to do so, please write his/her name in the box below. Cabin Mate
For Blueberry Cove Residential Camp, please choose a focus option, in order of your preference (first and second). Please Note: There is a limit of 12 participants per focus, sign up early to ensure your first choice! 1st Choice 2nd Choice
For Blueberry Cove Family Camp, please list each family member attending including names, ages, and gender.
Please check one:
Full payment is in the mail. Please remember that payment in full is what guarantees you a camp slot.
I wish to place the full payment on my credit card. Please note your Visa or MasterCard number, expiration date, the exact name of card holder and signature must be mailed to Tanglewood, at the above address, or phoned in before your registration is confirmed.
I wish to pay in three equal installments and agree to pay in full before June 1, 2008.
I have completed the Financial Aid Application and have mailed it along with my $25 nonrefundable deposit to hold my space.
Parent or Guardian Signature (this serves as your offical signature)

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Tanglewood logo These pages are currently being maintained by Tanglewood 4-H Camp and Learning Center. Send comments, questions, or inquiries to:

Summer Youth Camp - Jim Dunham, Camp Director or Cindy Dunham, Assistant Camp Director
Summer Camp Registration - Barbara Koster, Camp Registrar
Blueberry Cove Camp & Earth Connections - Leslie Hyde, Extension Educator Forestry & Environmental Education
4-H Earth Connections School Programs - Heather Francis, School Program Director
Elderhostel - Laura Sebastianelli, Adult and Family Programs Director
Earth Connections Volunteers - Laura Sebastianelli, Adult and Family Programs Director

Last modified on April 23, 2008->

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