Day Camp Registration Please enable JavaScript in your browser to complete this form.Parent/Guardian Name *FirstLastLayoutPhoneEmail *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAdditional Parent/Guardian NameFirstLastLayout (copy)Additional PhoneAdditional EmailHow Many campers are you registering?1234LayoutCamper Name *FirstLastGenderFemaleMaleNon-BinaryPlease specify pronouns and if they are more comfortable sharing a cabin with male or female campers. (To change and for quiet time)SessionSession 1: June24-28 +July 1-5Session 2: July 8-12 + July 15-19 (NOW FULL SELECT TO BE ADDED TO THE WAITLIST)BirthdayAllergies/ Dietary RestrictionsAnything else you want to us to knowCamper 2Name Camper 2 *FirstLastGenderFemaleMaleNon-BinaryPlease specify pronouns and if they are more comfortable sharing a cabin with male or female campers. (To change and for quiet time) Session Camper 2Session 1: June24-28 +July 1-5Session 2: July 8-12 + July 15-19 (NOW FULL SELECT TO BE ADDED TO THE WAITLIST)BirthdayAllergies/ Dietary Restrictions Anything else you want to us to knowCamper 3Name Camper 3 *FirstLastGenderFemaleMaleNon-BinaryPlease specify pronouns and if they are more comfortable sharing a cabin with male or female campers. (To change and for quiet time) (copy)SessionSession 1: June24-28 +July 1-5Session 2: July 8-12 + July 15-19 (NOW FULL SELECT TO BE ADDED TO THE WAITLIST)Birthday Allergies/ Dietary Restrictions Anything else you want to us to knowCamper 4Name Camper 4 *FirstLastGenderFemaleMaleNon-BinaryPlease specify pronouns and if they are more comfortable sharing a cabin with male or female campers. (To change and for quiet time)SessionSession 1: June24-28 +July 1-5Session 2: July 8-12 + July 15-19 (NOW FULL SELECT TO BE ADDED TO THE WAITLIST)BirthdayAllergies/ Dietary Restrictions Anything else you want to us to knowAre you seeking financial aid? NoYesSingle Camper PaymentDeposit – 1 Session – $ 75.00Deposit – Both Sessions – $ 150.00Full Payment, 1 Session – $ 350.00Full Payment 2 Sessions – $ 700.00Deposits are non-refundable, full payment is due 2 weeks before the start date. Two Campers PaymentDeposit – 1 Session x2 – $ 150.00Deposit – Both Sessions x2 – $ 300.00Full Payment, 1 Session x2 – $ 700.00Full Payment 2 Sessions x2 – $ 1,400.00Deposits are $75 per camper per session. Full session is $350 per camper per session. Deposits are non-refundable, full payment is due 2 weeks before the start date. Three Camper PaymentDeposit – 1 Session x3 – $ 225.00Deposit – Both Sessions x3 – $ 450.00Full Payment, 1 Session x3 – $ 1,050.00Full Payment 2 Sessions x3 – $ 2,100.00Deposits are $75 per camper per session. Full session is $350 per camper per session. Deposits are non-refundable, full payment is due 2 weeks before the start date. Four Camper PaymentDeposit – 1 Session – $ 300.00Deposit – Both Sessions – $ 600.00Full Payment, 1 Session – $ 1,400.00Full Payment 2 Sessions – $ 2,400.00Deposits are $75 per camper per session. Full session is $350 per camper per session. Deposits are non-refundable, full payment is due 2 weeks before the start date. Payment MethodDebit or CreditCheckCredit Card Payment *PayPal CheckoutCredit CardCard NumberExpiration DateSecurity CodeCard Holder NameI will send a checkYesThe deposit must be received in order to reserve your camper(s) spot(s) at camp. Make checks out to “Bearnstow” and mail to (Before June 1) Molly Hess, 37 Central Shaft Rd. Florida, MA 01247 (After June 1) Bearnstow Attn: Molly Hess, 84 Bearnstow Rd, Mount Vernon, ME 04352 Would you like to join our mailing list?YesNoOur Newsletter is weekly during our 10 week summer season with news and local events. Off Season we send very occasional emails (maybe 3-5 from fall-spring) for important announcements. Submit