CAMP SCATICO

     2020 Camper Enrollment Form

Camper's Name *
Camper's Name
Date of Birth *
Date of Birth
Camper's Name - Sibling 1
Camper's Name - Sibling 1
Date of Birth - Sibling 1
Date of Birth - Sibling 1
Camper's Name - Sibling 2
Camper's Name - Sibling 2
Date of Birth - Sibling 2
Date of Birth - Sibling 2
Another Home Address
Emergency Contact Information in Addition to Parent(s)/Guardian(s)
Payment Options (Please select ONLY one)
1) Pay By Mail
2) Pay By Electronic Check (please select ONE of the following options)
3) Pay By Credit Card (see payment link below and please select only ONE of the following options)
Signature
Payment Method Confirmation *
Provided Information *

Please note: If you selected Payment Option 3 (Pay by Credit Card) after submitting the Registration Form continue to "Pay By Credit Card Now" button below.