Camp COLEY
Create memories and friendships that last a lifetime!
When:
Sunday, August 10th through Saturday, August 16th, 2014.
Where:
Mount Allamuchy Scout Reservation
750 Waterloo Road , Stanhope, NJ 07874
Camp COLEY 2014
August 10 - 16
Who:
Boys & Girls entering 3rd grade through freshman in college.
Counselors-in-Training, 10th grade through freshman in college.
Prices:
Includes: programs, meals, lodging, awards, patches, t-shirt,
pizza party and 1 site picture!
 Campers ~ $360
 Counselors-In-Training ~ $340
 Leaders ~ $90
(Your leader fee is waived if your child comes to camp!)
Incentives:
 $10 discount with a $25 deposit paid by January 31, 2014.
Full deposit must be paid by April 2, 2014 and the remaining
balance by July 2, 2014.
 $10 discount per NEW camper you bring to camp.
 $10 discount per new adult volunteer you bring to camp for the week.
Payment Information:
 $175 non-refundable deposit due by April 2, 2014.
(less $25 if registered by January 31, 2014).
 Total balance is due July 2, 2014.
 No discounts or refunds after July 2, 2014.
Make checks payable to Camp COLEY
and mail with completed registration form to
Camp COLEY, PO Box 231, Abington, PA 19001
Register now and join us
for a fun-filled adventure!
CAMP COLEY IS A NON-PROFIT ORGANIZATION
www.campcoley.com ● info@campcoley.com
facebook.com/CampCOLEY
Camp COLEY 2014 Registration Form
Camper’s Name _________________________________________________
TO BE READ AND SIGNED BY PARENT/GUARDIAN:
Street Address: __________________________________________________
I am familiar with the time, place, leadership and other circumstances of the
Camp COLEY, Learning for Life, Patriots’ Path Council, Post 229, Group 229, and
Group 2402 program. My child has my permission to participate in these activities. He/She is in good physical condition.
______________________________________________________________
City __________________________________________________________
State ________________________
Zip Code ________________________
Home Phone # ______________-_________________- __________________
Parent Cell # ________________-________________- __________________
Contact Email Address
____________________________________@ ________________________
Camper’s Birth Date _____________________
Camper’s Age (as of 8/4/2014) __________
Camper’s Grade entering 9/1/2014 ___________
Is your child a first time camper? _____Yes
_____No
How did you find out about Camp COLEY?
______________________________________________________________
Sex _____Male
I waive and release the Camp COLEY, Learning for Life program and the group
leaders and staff members from any and all possible claims for injury to person or
property which might arise in connections with my child’s participation in this
program, except in the case of gross negligence. I understand that reasonable
measure will be taken to safeguard the health and safety of my child, and that I
will be notified as soon as possible in case of an emergency. In the event of sickness or accident, I authorize consultation with the doctor and the provision of
such medical services as necessary. I will underwrite all expenses involved which
are not covered by the insurance. I hereby authorized this in the event I cannot
be reached in an emergency.
Parent/Guardian
Name___________________________________________________________
Signature________________________________________________________
Date___________________________
_____Female
Allergy/Dietary Restrictions _______________________________________
______________________________________________________________
Shirt size (childrens medium to adult XXXL): _____________________
Were you referred by a friend? If so, who:
______________________________________________________________
For more information about Camp COLEY
visit our website at www.campcoley.com,
call Gladys at 215-233-5709 or Karyn at 973-252-2949,
or email us at info@campcoley.com
Credit Card payment available, please call for more information.
TO BE READ AND SIGNED BY PARTICIPATING YOUTH:
With my parents, I have completed the camp information forms and will assume
responsibility for restricting any activities agreed upon and listed on the camp
forms. I will exercise good judgment in regards to my own health, safety, and
well being, while participating in the Camp COLEY program.
I understand that the use of cell phone at Camp COLEY is prohibited. If the Camp
COLEY staff discovers my cell phone, they will confiscate my cell phone immediately and return it to my parent or legal guardian at the time of departure.
Youth Signature _________________________________________________
Date _______________________
KK-FF