Contact Information

Applicant's Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Personal Information

Date of Birth
Age
Mother's Name	Occupation
Father's Name	Occupation
Emergency Contact Person	Phone

Education                               

Interests

Choose one of the following camp sessions:

Session 1 June 13 - June 26
Session 2 June 30 - July 13
Session 3 July 16 - July 29

I attest that the above information is accurate and true to the best of my knowledge and available for public record at the discretion of the camp director.

Applicant Name 

Parent Name

Please note: If application is submitted online, application is not complete until $500 non-refundable deposit is received. Payment can be made online or by mail to PO Box 310318 Atlanta, GA 31131