Camp Thoreau Registration

Summer 2012 Camp Registration

Complete the form below to start the registration process. If you require Transportation or Extended Day services, complete those respective forms (links can be found in the left side bar).

Camper First Name *

Camper Last Name *

Street *

Town *

State *

Zip Code *

Date of Birth *

Gender *

Male

Female

School

Entering Grade in Fall 2012 *

Previous Thoreau Camper?

yes

Mother/Guardian Name

Father/Guardian Name

Mother/Guardian eMail

Father/Guardian eMail

Address (if different from camper)

Primary Contact Name *

Primary Contact Cell Phone *

Primary Contact Employer

Primary Contact Business Phone *

How did you hear of Camp Thoreau?

Division (grade entering fall 2012) *

Contribution to Campership Fund

$25

$50

$75

$100

Who referred you to Camp Thoreau? (optional)

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Community Excellence Award
Family Business Association Community Excellence Award

The Thoreau Club
275 Forest Ridge Road,
Concord, MA 01742
info@thoreauclub.com
(978) 831.1349

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Camp Thoreau Registration