Please make a copy of this form for each child.

Print this form and mail it to:

Camp Farley
615 Route 130
Mashpee, MA 02649

Name:
 
Male
  
Female
Date of Birth:
i.e. (mm/dd/year)


T-Shirt Size:
Youth S (6-8)
Youth M (10-12)
Youth L (14-16)
Adult S
Adult M
Adult L
Adult XL

School Grade in September  

Cabin "Buddy" Request
limited to 2 of similar grade

Day Camp "Group" Request:
limited to 2 of similar grade

Winter Mailing Address (If different from summer)
Street
Town
State
Zip Code

Home Telephone
Mom's Cellphone
Dad's Cellphone
Mom's Work Telephone
Dad's Work Telephone

Summer Mailing Address
Street
Town
State
Zip Code
Telephone
Dates at Summer Address

Instructions:
Note Camp Program and beginning date for each session (i.e. week) offered. Indicate the week(s) attending with a check and multiply the number of weeks times the Cost/wk to calculate totals accordingly.

Camp Program
Wk #1
Wk #2
Wk #3
Wk #4
Wk #5
Wk #6
Wk #7
Wk #8
Cost/
Wk
Total
Cost
Deposit/
Wk
Deposit
Overnight Program
(Grades 3 -10)
6/29
76
7/13
7/20
7/27
8/3
8/10
N/A
$415
$100
Day Program
(Grades 1 - 7)
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
$265
$75
Horseback Riding
(Grades 4 -10)
wk 1
wk 2
wk 3
wk 4
wk 5
wk 6
wk 7
wk 8
$170
$50
Email Program/$2 wk up to 5 emails
wk 1
wk 2
wk 3
wk 4
wk 5
wk 6
wk 7
wk 8
$2
 
Counselor In Training - Age 15 or going into the 10 th grade . (Call our office for information and application)
     
*Deposit must accompany this form.
TOTAL COST & DEPOSIT DUE =
 

PARENTAL AGREEMENT: I have read and understand Camp Farley's Registration and camp policies,
agree to abide by the rules of the Camp and will not hold the
Camp responsible or liable for any injury to camper or equipment.

I have read and I understand and accept Camp Farley's Refund and Cancellation policy.


Parent/Guardian Signature:

(NOTE: There will be a $30 fee for returned checks.)

Make checks payable to Camp Farley. Upon receipt of this registration, a
Confirmation Packet will be mailed within two weeks.