SB2W HOME PAGE • SB2W LAKE GLORIA • SB2W AT THE QUE • SB2DUB CITIKIDZ
2010 APPLICATION FOR ENROLLMENT
Please complete all information. One Name Only Per Application.
If selecting more than one option, please specify order of preferences in comment area.
Camp
Summer One
First Term
Second Term
Third Term
Fourth Term

June 10-June 18
June 20-July 2
July 4-July 16
July 18-July 30
Aug 1-Aug 13

June 10-June 18
June 20-July 2
July 4-July 16
July 18-July 30
Aug 1-Aug 13

TUITION: Summer One tuition is $440…$460 if paid by credit card.  Two Week tuition is $640…$660 if paid by credit card. $100 should accompany each application.  The tuition balance is due on April 1 unless other arrangements have been made.  After acceptance, $10 is not refundable.  After January 1, $50 is not refundable.  After March 1, full deposit is not refundable.  Full Tuition is not refundable within three weeks prior to your term.  Full refunds are available from the waiting list any time.
Note: Online Registration requires the deposit to be paid by Credit Card. However, if the term is full and you are put on a wait list, we will not charge your Credit Card.
Name of Camper*   Nickname
Address*
City*   State*
  Zip*
Family Phone w/Area*   Fax
Family Email*      
Present Age*   Gender*
Present Grade(09-10)*   Birthdate*
Social Security(Optional)      
 
Parents' Names (Dr., Rev., Mr. and/or Mrs.)*
Are Both Parents Living?*   Is Camper Living with both*
If separated, who receives camp correspondence?*
Church you attend
Father's Business or Profession   Cell Phone
Mother's Business or Profession   Cell Phone
Insurance Carrier*   Policy Number*
 
How many years have you completed at SB2W Resident Camp?
If you or a sibling were a former camper, please indicate team:
If you have attended a SB2W Day Camp, where?
If this is your first year, who most influeced your decision to attend SB2W?
What do you most desire that your Camper get out of Camp?
List and discuss any physical or psychological concerns for your Camper
Additional Comments/Questions/Concerns
 
CREDIT CARD INFORMATION
Please Note: All on-line applications must pay the deposit by Credit Card. Tuition balance my be paid by Credit Card or Check.
Deposit
  Charge my $100 deposit to my Credit Card.
Balance
   
Name on Card
Card Number
Expiration
Card Type
CONDITIONS OF APPLICATION*
I Approve the application above and the conditions listed below. I have written any necessary and pertinent information concerning our family and our camper. In case of illness I hereby give permission for medical care by physician and/or hospital chosen by Camp Director/Doctor/Nurse. I understand that every effort will be made to contact parent/guardian in case of emergency.
 
 
*Field is required.
 
SB2W HOME PAGE • SB2W LAKE GLORIA • SB2W AT THE QUE • SB2DUB CITIKIDZ
 
Summer's Best Two Weeks • 111 Lake Gloria Road • Boswell, PA 15531-2509 • 814.629.9744 • info@sb2w.org
?? 2007, SUMMERS BEST TWO WEEKS