Registration | Culture Camp

Camper and CIT Registration Form for June 1-4, 2010

Cost for Culture Camp 2010 is $250 per camper, with a discount of $25 for early registration. Early registration ends March 15, 2010. CIT cost is $150. CITs must attend training from 10:00 am May 31 until the beginning of camp session on June 1, 2010. Some scholarships are available.

*New for this year: Medical form signed by doctor and releases for working cooperatively with Holt International.

Camper's Name*
First Name
Middle Initial
Last Name
Prefered Name

Address*
Address
City
State
Zip Code
Camper's Email Address

General information*
Gender
Date of Birth
Age at time of Camp

Adoption Information*
Adoptoin Country
Ethnicity
Adoption Type
Adoption Agency

Camp Information*
Have you attended Culture Camp before?
Yes No
If yes, what year(s)
Cabin Request: Who do you want in your cabin?
Shirt Size

Parent's Information*
Parent's First and Last Name
Address (If different from camper)
City
State
Zip Code
Home Phone
Cell Phone
Work Phone
Email Address

Parent / Family Volunteering
I would be willing and able to volunteer for camp by:
Talking about Culture Camp to other families
Providing transportation for staff
Fundraising

Comments or concerns regaurding registrations
Comments/Questions About Registrations

cforms contact form by delicious:days

Register and pay through the mail

*Note: You do not need to fill out an online application if you register through this method.

To complete the registration you must:

• Download the Health and Examination Form and have child's doctor sign and send before camp starts.
• Download and sign the Media Release Form.
• And lastly download and sign the Liability Form.

After downloading the forms, please choose to pay for a camper or CIT.

By clicking the "Pay for Camp" button you will be directed to Culture Camp's Paypal payment page. If you do not have a Paypal account you can pay through your credit or debit card with the panel on the left side.