A DEPOSIT OF $250.00(CHECK OR MONEY ORDER), CREDITED TOWARDS TUITION, MUST ACCOMPANY EVERY APPLICATION

NAME OF CAMPER__________________________________ADDRESS_____________________________________________ CITY__________________________________________________STATE_____________________ZIP____________________ PARENT OR LEGAL GUARDIAN_____________________________________________________________________________ PHONE____________________________________________EMERGENCY PHONE____________________________________ AGE______________________________________________HT_________WT_________ SPECIAL INSTRUCTIONS (ROOMMATE, DIET, ETC)________________________________________________________________

A DEPOSIT OF $250.00 (CHECK OR MONEY ORDER), CREDITED TOWARD TUITION. MUST ACCOMPANY EVERY APPLICATION MAILED TO ASBC/P.O. BOX 302, MAHWAH NJ 07430. REPORTING INSTRUCTIONS WILL BE SENT BY RETURN MAIL

SIGNATURE OF PARENT OR GUARDIAN_____________________________________________DATE_________

HOW DID YOU HEAR ABOUT OUR CAMP ____FRIEND ____RELATIVE ____WEBSITE ____NEWSPAPER(NAME)_______________

HOME

APPLICATION PG. 1