Application

To guarantee a place, a NON-REFUNDABLE DEPOSIT OF $150 PER CHILD IS DUE ONCE THIS APPLICATION IS FILLED OUT.
Upon submitting the application you will either be transferred to paypal or you will mail in a deposit depending on your choice below.
Please use a new application for each child.

Please print out and return the Medical Form and our school authorization form.
Please return to us by email: gina@campsummerset.org OR by mail:
The Learning Institute c/o Registrar
PO Box 186 Goldens Bridge, New York 10526

If you would like to complete the forms online please click on one of the options below:
Medical form and School Authorization form


Parent's First Name*:
Parent's Last Name*:
Address*:
City*:
State*:
Zip*:
Email Address*:
Parent's Home Phone*:
Parent's Cell Phone*:
Child Information:
Child's First Name*:
Child's Last Name*:
Child's Current Grade*:
Teacher's Name:
Child's Date of Birth*:
Child's School*:
School Address*:
City*:
Zip*:
Interested in:
Enrichment Program 12:45 - 2:15pm (additional $300)
My child would like to be in the same group as (Choose one friend. Will try to accommodate:
Has your child attended camp before?:
Yes
No
May we have permission to contact your child's teacher?:
Yes
No
May we have permission to publish your child's photo in future camp brochures or camp materials?:
Yes
No
Please indicate how you about us.*:
Pay by*: