Registration Form
Your adventure awaits!
Camper's Information
Number of campers you are registering
1
2
3
4
Camper Name (1st camper)
*
Date of Birth - Month, Day, Year (1st camper)
*
Camper Name (2nd camper)
*
Date of Birth - Month, Day, Year (2nd camper)
*
Camper Name (3rd camper)
*
Date of Birth - Month, Day, Year (3rd camper)
*
Camper Name (4th camper)
*
Date of Birth - Month, Day, Year (4th camper)
*
Parent/Guardian Information
Parent/Guardian
*
First Name
Last Name
E-mail
*
Contact Phone
*
Home Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Emergency Contact
Full Name
*
First Name
Last Name
Emergency Contact Number
*
Relationship to Child
*
Medical/Health Information
Name of Physician or Clinic/Hospital
Phone Number
-
Allergies or medical conditions? Check all that apply
*
Food
Medication
Environmental
Asthma
Other
Please explain any allergies or medical conditions
*
0/150
Payment and Terms & Conditions
I agree to the terms & conditions described above.
*
Parent/guardian must type first and last name above and sign below to consent.
Parent/Guardian Please Sign Document
*
Bus Captain's Name (if applicable)
Please answer how you would like to pay for your child's/children's Camp Advance registration fees.
I prefer to pay with credit card.
I prefer to pay with cash or check.
Please select which weeks your child/children will be attending Camp Advance. You can pay with cash or check at the camp office.
All 5 Weeks of Camp (1st camper) $325
All 5 weeks of Camp (2nd camper) $300
All 5 weeks of Camp (3rd camper) $275
June 14-18 - (1st camper) $65
June 14-18 - (2nd camper) $60
June 14-18 - (3rd camper) $55
June 15-19 - 2020 Olympics (4th camper) $55
June 22-26 - 2020 Olympics (1st camper) $65
June 22-26 - 2020 Olympics (2nd camper) $60
June 22-26 - 2020 Olympics (3rd camper) $55
June 22-26 - 2020 Olympics (4th camper) $55
July 13-16 - Music Camp (1st camper) $85
July 13-16 - Music Camp (2nd camper) $80
July 13-16 - Music Camp (3rd camper) $75
July 13-16 - Music Camp (4th camper) $75
July 20-24 - Outdoor Week (1st camper) $85
July 20-24 - Outdoor Week (2nd camper) $80
July 20-24 - Outdoor Week (3rd camper) $75
July 20-24 - Outdoor Week (4th camper) $75
July 27-31 - 2020 Olympics (1st camper) $65
July 27-31 - 2020 Olympics (2nd camper) $60
July 27-31 - 2020 Olympics (3rd camper) $55
July 27-31 - 2020 Olympics (4th camper) $55
Transportation - $20 per week (LaPorte & Lake Counties)
Transportation - $10 per week (Porter County)
Total
My Products
prev
next
( X )
ALL 5 WEEKS OF CAMP (1st camper)
$
315.00
ALL 5 WEEKS OF CAMP (2nd camper)
$
290.00
ALL 5 WEEKS OF CAMP (3rd camper)
$
265.00
ALL 5 WEEKS OF CAMP (4th camper)
$
265.00
June 15-19 - 2020 Olympics (1st camper)
$
65.00
June 15-19 - 2020 Olympics (2nd camper)
$
60.00
June 15-19 - 2020 Olympics (3rd camper)
$
55.00
June 15-19 - 2020 Olympics (4th camper)
$
55.00
June 22-26 - 2020 Olympics (1st camper)
$
65.00
June 22-26 - 2020 Olympics (2nd camper)
$
60.00
June 22-26 - 2020 Olympics (3rd camper)
$
55.00
June 22-26 - 2020 Olympics (4th camper)
$
55.00
July 13-16 - Music Camp (1st camper)
$
85.00
July 13-16 - Music Camp (2nd camper)
$
80.00
July 13-16 - Music Camp (3rd camper)
$
75.00
July 13-16 - Music Camp (4th camper)
$
75.00
July 20-24 - Outdoor Week (1st camper)
$
85.00
July 20-24 - Outdoor Week (2nd camper)
$
80.00
July 20-24 - Outdoor Week (3rd camper)
$
75.00
July 20-24 - Outdoor Week (4th camper)
$
75.00
July 27-31 - 2020 Olympics (1st camper)
$
65.00
July 27-31 - 2020 Olympics (2nd camper)
$
60.00
July 27-31 - 2020 Olympics (3rd camper)
$
55.00
July 27-31 - 2020 Olympics (4th camper)
$
55.00
Transportation (LaPorte & Lake Counties) per week
$
20.00
Transportation (Porter County) per week
$
10.00
Enter coupon
Apply
Total
$
0.00
Credit Card
First Name
Last Name
Credit Card Number
Security Code
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
Expiration Year
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Save
SUBMIT
Should be Empty: