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Please fill out a separate form for each camper. Camper forms are online and need to be filled out one week prior to arrival.

Camper Name
Address
City
State
Zip Code
Home Phone
Alt. Phone
Email
Grade in Fall 2008
Birth Date
Gender		Male  Female
New Camper?		Yes  No
T-Shirt Size		Small   Medium   Large   X-Large
Church
Church City
Parent/Guardian Name(s)
Daytime Phone Number(s)
Individuals authorized to pick up my child other than parent/guardian named above (Required)
Check which program session(s) the camper will attend:
Camp Ages Date Cost Welcome to Camp 7-11 July 20-25 $425 Junior Camp 7-11 June 28-July 3 $425/1 wk. $795/2 wks. Junior Camp 7-11 July 6-11 Junior Camp 7-11 July 13-18 Junior Camp 7-11 July 20-25 Junior Camp 7-11 July 27-August 1 Junior Day Camp 6-11 July 6-11 $250 Amazing Journey 12-14 June 28-July 3 $425/1 wk. $795/2 wks. Amazing Journey 12-14 July 6-11 Amazing Journey 12-14 July 13-18 Amazing Journey 12-14 July 20-25 Amazing Journey 12-14 July 27 - August 1 Adventure Base 15-18 June 28-July 3 $425 Adventure Base 15-18 July 6-11 $425 Advanced Adventure Base 15-18 July 13-18 $525 Leadership Challenge 15-18 July 20-25 $425 Advanced Leadership Challenge 15-18 July 27 - August 1 TBD Performing Arts Camp 9-14 July 13-18 $425 Spring Music Work Week 12-18 April 20-26 (please register by March 1, 2008) $425 Family Camp All Ages May 25-26 (please register by April 1, 2008) $30 per person; $100 maximum per family

PAYMENT INFORMATION

Deposit: A non-refundable deposit of $125 by check or credit card is required.

Balance Due: Remaining balance is due no later than June 1, 2008. For Music Work week, balance is due by March 15th. Family Camp balance is due by April 15th.

Refund Policy: For all cancellations initiated at least 30 days prior to the first day of the session, the session fee, minus the $125 deposit, will be refunded or can be transferred to another 2008 summer session. No refund will be given for cancellations initiated less than 30 days prior to the session, except in the case of illness, accident or family emergency.

Early Bird Discount: Register by January 1, 2008, and receive a 5% discount.

Online Discount: Register online by January 31, 2008, and receive a 5% discount.

Multi-Session Discount: Receive a 10% discount on sessions for a single camper after the first registration.

Sibling Discount: All siblings, after the first registered camper, will receive a 10% discount.

A limit of 3 discounts may be applied to each camper.

FINANCIAL AID:
Camp Bement believes that every child deserves a summer camp experience, regardless of a family’s means. Financial assistance is available, upon eligibility, in the form of parish scholarships, aid from Bement Camp, and meal assistance from the state of Massachusetts. Please contact your local parish for any scholarship assistance offered. You can also apply for a scholarship by completing the Summer Scholarship Form available in your confirmation packet, or by calling the Bement office. All scholarship applications must be received by May 15th. NOTE: Please inform camp office about any third-party scholarships you receive so that we may coordinate payments.

Make Checks Payable to: Bement Camp and Conference Center

Send Registration Payments to:
Bement Camp and Conference Center
73 Jones Road
Charlton, MA 01507