Lake Adventure Camp Registration If you have more than one child to register please contact Elisa Nelson 802-475-2022 x105. - Step 1 of 5How'd you hear about our summer camps? *Front Porch ForumPrevious ExperienceWord Of MouthKidsVTFacebookTwitterBrochure, postcard or flyerOtherOther? Please explain. *NextCamper Name *FirstLastCamper Birthdate *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Camper Entering Grade: *2nd - 4th5th - 7th8th - 12thHow many camps? *1 Camp ~ $3252 Camps ~ $617.503 Camps ~ $9104 Camps ~ $1202.505 Camps ~ $1495Note: does not include cost of kits. Grade 2-4 max 3 CampsGrade 5-7 max 5 CampsGrade 8-12 max 2 CampsChoose Camps For Camper #11st Camp *One and only Fish camp (Jun. 24-28)The Original Lake Adventure Camp (Jul. 8-12)The Original Lake Adventure Camp (Jul. 15-19)Lake Adventure Camp w/Snorkeling (Aug. 5-9)2nd Camp *One and only Fish camp (Jun. 24-28)The Original Lake Adventure Camp (Jul.8-12)The Original Lake Adventure Camp (Jul. 15-19)Lake Adventure Camp w/Snorkeling (Aug. 5-9)none3rd Camp *One and only Fish camp (Jun. 24-28)The Original Lake Adventure Camp (Jul.8-12)The Original Lake Adventure Camp (Jul. 15-19)Lake Adventure Camp w/Snorkeling (Aug. 5-9)none1st Camp *18th Century Camp (Jul. 1-5)Heavy Metal Mania ( Jul. 8-12)Lake Adventure Camp w/Snorkeling (Jul.22-26)Build Your Own Adventure Robot (Jul. 29-Aug 2) (+$170 for kit)Lake Adventure Camp w/Snorkeling (Aug. 12-16)2nd Camp *18th Century Camp (Jul. 1-5)Heavy Metal Mania ( Jul. 8-12)Lake Adventure Camp w/Snorkeling (Jul.22-26)Build Your Own Adventure Robot (Jul. 29-Aug 2) (+$170 for kit)Lake Adventure Camp w/Snorkeling (Aug. 12-16)none3rd Camp *18th Century Camp (Jul. 1-5)Heavy Metal Mania ( Jul. 8-12)Lake Adventure Camp w/Snorkeling (Jul.22-26)Build Your Own Adventure Robot (Jul. 29-Aug 2) (+$170 for kit)Lake Adventure Camp w/Snorkeling (Aug. 12-16)none4th Camp *18th Century Camp (Jul. 1-5)Heavy Metal Mania ( Jul. 8-12)Lake Adventure Camp w/Snorkeling (Jul.22-26)Build Your Own Adventure Robot (Jul. 29-Aug 2) (+$170 for kit)Lake Adventure Camp w/Snorkeling (Aug. 12-16)none5th Camp *18th Century Camp (Jul. 1-5)Heavy Metal Mania ( Jul. 8-12)Lake Adventure Camp w/Snorkeling (Jul.22-26)Build Your Own Adventure Robot (Jul. 29-Aug 2) (+$170 for kit)Lake Adventure Camp w/Snorkeling (Aug. 12-16)none1st Camp *Basic Boating Certification (Jun. 24-28) (+$29.50 for Lifetime VT Boater Education Card)Wooden Boat Building (Aug. 5-9) (+$325 for kit)2nd Camp *Basic Boating Certification (Jun. 24-28) (+$29.50 for Lifetime VT Boater Education Card)Wooden Boat Building (Aug. 5-9) (+$325 for kit)noneTotal$ 0.00PreviousNextPick Up & Drop OffAdditional Services *Early Drop Off - $40Late Pick Up- $40Early Drop Off and Late Pick Up - $80Not neededPlease review Terms & Conditions for more information.Free Shuttle ServiceBurlington/Shelburne RouteMiddlebury/Vergennes RoutePick-up/Drop-off PointKmart parking lot on Shelburne Road in South BurlingtonShelburne SupermarketPick-up/Drop-off PointBridge School parking lotVergennes Park and Ride (RT 7 and 22A)Total$ 0.00Alternate Individuals Allowed To Pick up.Please list contact information for second parent or other approved individuals allowed to pick up your child. One per line.Emergency Contact InformationPlease enter the name of the parent or guardian who should be contacted in the case of an emergency.Relationship *ParentSiblingRelativeFriendName *FirstLastEmail *Phone *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePreviousNextMedical InformationMedical ConditionPlease tell us about any medical issues we should be aware of, or any conditions that would prohibit a camper from participating in physical exercise or outdoor activities. AllergiesPlease list the camper's allergies if any. MedicationsIs the camper taking any medications? If yes, please list. Special NeedsDoes the camper have any special needs or learning disabilities that we should know about? This does not necessarily prevent participation.PreviousNextTotal & PaymentTotal$ 0.00Credit CardCard NumberSecurity CodeName on CardExpirationMM123456789101112/YY1920212223242526272829Important Information and ConsentTerms & Conditions *I agree and give consent.Please read the Important Information and Consent.WebsiteSubmit Share this:Click to share on Facebook (Opens in new window)Click to share on Pinterest (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)