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Summer Address:
      5300 W. Loveland Rd
      Madison, OH 44057

2014 Cedarbrook Camp™ of Ohio Online Camper Registration Form

You must provide a valid email address for us to contact you!

Instructions

Complete one registration form for each child. You will have to return to the registration page and click on the online registration link again to begin a new registration for each additional camper. If you wish, you may make one PayPal payment; just be sure to enter the correct amount for all your registrations.

Camp Fee: $230
(For registrations postmarked between April 1st and May 31st.
This cost includes the Registration Deposit.)

Early-Bird Discount: $20 off Camp Fee (For registrations postmarked no later than March 31st: Camp Fee=$210.)

Late Fee: $30
(For registrations postmarked after May 31st: Camp Fee=$260.)

Registration Deposit: $100 per child for each week attending
(The Registration Deposit is the first $100 of each camper's Camp Fee and is not in addition to the Camp Fee. The Registration Deposit must accompany each camper's registration and is non-refundable. Your child is not considered registered without receipt of the Registration Deposit.)

You must enter a valid email address for us to process your registration(s).

You will receive a confirmation packet in the mail.

Personal Information
Camper Name: Age:
Birthday: Grade in Fall:
Number of Years at Stony Glen: Gender: Boy Girl

Name of parent/guardian: Home Address:
Home Phone: City:
Cell Phone: State:
Work Phone: Zip:

Parent Email: Camper Email*:

Church you attend: Church City:
Church State: Church Zip:

Check the camper's preferred tee-shirt size for their free CCO 2014 Camper Tee.

  Tee-shirt size: Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large


Options
Cabin mate preference
(not guaranteed):
Cabin mate grade in fall:

Check which week(s) you are applying for:

Week 1 (July 13-19)

Please select one option for Week 1

Girls' Camp - Regular Camper (Girls: Grades 3-12)
CILT 2 (must also sign up for week 2)
CILT 3 (regular camper fee; must also sign up for week 2 and precamp training)

 

Week 2 (July 20-26)

Please check one option for Week 2

Girls' Camp - Regular Camper (Girls: Grades 3-12)
Outpost (Girls entering grades 10-12)
CILT 1 (must also sign up for week 3; CILT 1 Girls will also be on Outpost)
CILT 2 (must also sign up for week 1)
CILT 3 Internship (no fee; must also sign up for week 1 and precamp training)

 

Week 3 (July 27 - Aug 2)

Please check one option for Week 3

Girls' Camp - Regular Camper (Girls: Grades 3-12)
CILT 1 Girls (must also sign up for week 2)
CILT 1 & 2 Boys (must also sign up for week 4)
CILT 3 Boys (regular camper fee; must also sign up for week 4 and precamp training)

 

Week 4 (August 3-9)

Please check one option for Week 4 - Boys' Camp

Boys' Camp - Regular Camper (Boys: Grades 3-12)
CILT 1 & 2 Boys (must also sign up for week 3)
CILT 3 Boys Internship (no fee; must also sign up for week 3 and precamp training)

 

Pre-Camp Training (July 9-12) — REQUIRED for CILT 3 GIRLS and BOYS Only (no additional cost)


  Horsemanship Classes
  (Grades 5-12)
Horses Week 1 ($45 fee must accompany the registration deposit)
Horses Week 2 ($45 fee must accompany the registration deposit)
Horses Week 3 ($45 fee must accompany the registration deposit)
Horses Week 4 ($45 fee must accompany the registration deposit)

  .22 Rifle Program
  (Grades 7-12)
Due to the rising cost of ammunition, the Riflery Activity fee will now be $15/camper. If there is a chance that your child will be taking Riflery at CCO this year, please make sure that you bring enough money to cover the cost, as this fee is generally deducted from the camper's Tuck Account.



You have permission for my child to attend camp, participate in all camp activities, and receive emergency treatment if necessary. My child may be photographed and/or videotaped (unless otherwise indicated below) and pictures and/or video may be used for promotion and publication. I hereby release Cedarbrook Camp from any responsibility for injuries my child may sustain during his/her time at camp.

Please do not photograph or videotape my child.
*Please do not contact my child via email.


Payment and Signature

I am including a PayPal payment for $100/week to cover my child's non-refundable registration deposit. Please include a $2.50 PayPal fee.

Yes — The name on the credit card is:

No — I will mail a check to the Registrar

Please make check payable to: Cedarbrook Camp of Ohio

Mail to:

Elizabeth Wilsey
1585 Plantation Drive
Hudson, OH 44236

 

Signature: