MAE Summer Camp 2022 Application Form

Complete 1 Application per household
MAE Summer Camp will take place

June 6th - July 22nd from 8A - 4P.

W e will be closed July 11th - July 15th.

Camp Site: Greater St. Stephen FGBC [Morton Hall]

5600 Read Blvd, New Orleans, La and 70127
Registration Fee: $35 per child (includes camp shirt)

Additional Youth Shirt $10

Adult Shirts S-XL $15 XXL and Up $25
Check Appropriate Choice

New (2022 camp year) Returning (2021 camp year) Both
Tuition Options

1 child = $60 per week /$360 2 children= $75 per week/$450 3 children= $90 per week/$540 4 children= $105 per week/$630 5 children or more = $135 per week/$810
Child’s Name

First Name Last Name
Date of Birth

Month Day Year
Date
Age
Name of School
Grade Completed
Additional Siblings Attending Camp (Full Name, Age, Date of Birth)
Name of Parent/Guardian/Primary Contact

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Cell Number
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Email
example@example.com
Emergency Contact #1

First Name Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Emergency Contact #2

First Name Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Youth T Shirt Size (included all sibling sizes)
Adult Size (if you want to purchase a shirt)
Does your child have any medical conditions, allergies, or special needs the staff should know? Academic and Behavioral IEPs are included.
Should be Empty:

Complete 1 Application per household