IMPORTANT! Along with this registration form, you will also need our standard forms for all campers.
Please open THIS PDF, print, and mail or fax the forms to 
our Catalina Office.

STUDENT NAME

_________________________________________________________________________________________

ADDRESS

_________________________________________________________________________________________

CITY/STATE

_________________________________________________________________________________________

ZIP ___________________________ CHILD’S AGE __________________ GENDER _______________

DAY PHONE ALTERNATE PHONE

(_______)_______ - __________________________ (_______)_______ - ___________________________

NAME OF PARENT/GUARDIAN

_________________________________________________________________________________________

Weeks Requested:

o June 24-29	WEEK ONE - CATALINA ISLAND	o TEEN CAMP	o KIDS CAMP
o July 1-6	WEEK TWO - CATALINA ISLAND	o TEEN CAMP	o KIDS CAMP
o July 8-13	WEEK THREE - CATALINA ISLAND	o TEEN CAMP	o KIDS CAMP
o July 15-20	WEEK FOUR - CATALINA ISLAND	o TEEN CAMP	o KIDS CAMP
o July 22-27	WEEK FIVE - CATALINA ISLAND	o TEEN CAMP	o KIDS CAMP
o July 29-Aug3	WEEK SIX - CATALINA ISLAND	o TEEN CAMP	o KIDS CAMP
o Aug 5-Aug10	WEEK SEVEN - CATALINA ISLAND	o TEEN CAMP	o KIDS CAMP

$150 deposit is non-refundable. No refunds less than 30 days prior to your camp start date.

 

Amount $____________________ Check # ______________ or provide your credit card information

MC or VISA Credit Card # ________________________________________ Expiration _______________

WHERE DID YOU HEAR ABOUT OUR PROGRAM?
_________________________________________________________________________________________

 

Send this form and check to :

Mountain & Sea Educational Adventures
P.O. Box 950
San Pedro, CA 90733
PHONE: 310-427-7845
FAX: 310-684-5685
EMAIL: info@mountainandsea.org

or Fax this Registration Form and CC # To (310)-684-5685