REGISTRATION FORM

Part 1: Camper Information
Camper's Name*

First NameLast Name
Preferred Name / Nickname (if applicable)
Gender*

FemaleMaleNon-BinaryOther
Preferred Pronouns
Date of Birth*

MonthDayYear
Date
Entering Grade Fall of 2025
School Currently Attending
Camper's Email
example@example.com
Camper's Phone Number (if applicable)
Please enter a valid phone number.
Name of Parent/Guardian #1*

First NameLast Name
Home Address of Parent/Guardian #1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email of Parent/Guardian #1*
example@example.com
Cell Phone Number of Parent/Guardian #1*
Please enter a valid phone number.
Name of Parent/Guardian #2

First NameLast Name
Email of Parent/Guardian #2
example@example.com
Cell Phone Number of Parent/Guardian #2
Please enter a valid phone number.

Med-o-lark's Summer 2025 Tuition

Length	Dates	Session	Tuition
2 Weeks	June 26 - July 10	1A	$4,995
2 Weeks	July 10 - July 23	1B	$4,995
2 Weeks	July 24 - Aug 7	2	$4,995
2 Weeks	Aug 7 - Aug 20	3	$4,095
4 Weeks	June 26 - July 23	1	$8,000
4 Weeks	July 10 - Aug 7	1B & 2	$8,000
4 Weeks	July 24 - Aug 20	2 & 3	$7,295
6 Weeks	June 26 - Aug 7	1 & 2	$11,495
6 Weeks	July 10 - Aug 20	1B, 2 & 3	$10,995
8 Weeks	June 26 - Aug 20	Full Summer	$13,495

Secure your spot! Which dates would you like to enroll for?*

2 Weeks: June 26 - July 10 (Session 1A)2 Weeks: July 10 - July 23 (Session 1B)2 Weeks: July 24 - Aug 7 (Session 2)2 Weeks: August 7 - August 20 (Session 3)4 Weeks: June 26 - July 23 (Session 1)4 Weeks: July 10 - August 7 (Session 1B & 2)4 Weeks: July 24 - Aug 20 (Session 2 & 3)6 Weeks: June 26 - August 7 (Sessions 1 & 2)6 Weeks: July 10 - Aug 20 (Session 1B, 2 & 3)Full Summer: June 26 - August 20
T-Shirt Size

Youth Small/Medium (7-10 year old)Youth Large/XL (8-12 year olds)Adult SmallAdult MediumAdult Large, XL or XXL
Does your camper have any cabinmate requests? (New families: Med-o-lark is a warm and welcoming environment. About half of our camp will be new this summer.)*

YesNo
Please share any details on cabinmate requests
Does your camper have any siblings attending camp?*

YesNo
Name(s) of sibling(s) attending camp (if applicable)
Siblings get 10% off
Age(s) of sibling(s) attending camp (if applicable)
Previous camps attended (if applicable)
Do you have any concerns regarding your child's behavioral or social life? Have you encountered any difficulty at home, school, or at a past camp?
How did you hear about Camp Med-o-lark? E.g. Social Media, Internet Search, Referral Agency, Camp Fair, Family/Friend. If on the web, please include the website so we can thank them.
Would you be interested in enrolling in any of these exciting out-of-camp adventures?

Whitewater Rafting ($125) - July 3, July 17, July 31 or Aug 13Acadia National Park ($50) - July 6 or Aug 10Moose Mountain Mini Golf & Adventure Park ($50) - July 10Portland Sea Dogs Baseball ($50) - July 13 or Aug 3Coastal Maine Foodie Tour ($125) - July 27
Would you be interested in horseback riding? This is an elective afternoon activity and we will transport campers to Lupine Farms in Vassalboro, Maine (30 mins away). Lupine Farms is the home of the Colby College equestrian team.

No thanks!Yes, as a 4-day activity ($300)Yes, as an 8-day activity ($600)Yes, as a 12-day activity ($900)Yes, as a 16-day activity ($1,000)
By registering your camper, you agree to Camp Med-o-lark's Terms & Conditions.
Please acknowledge you have read our Terms & Conditions*

I acknowledge Camp Med-o-lark's terms and conditions
How would you like to pay for your camper's $750 deposit? Please select one.*

By credit cardBy ACH/wireBy check
Please make your check payable to Camp Med-o-lark. Our mailing address is:

82 Medolark Rd

Washington, ME 04574

Please email us at welcome@medolark.com to let us know you are paying by check.

My Products

Secure Your Spot - Deposit Secure your camper's spot with a $750 deposit.

$750.00

Any Amount

$1.00 Quantity

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

Part 1: Camper Information