Enroll | Camp Winnebago

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Camper Application

Camper's Name

First Name *

Last Name *

Present Age

Birth Date

School attending

Current grade

Name camper likes to be called

Social Security Number

Camper's home address

Street Address

Street Address Line 2

City

Postal / Zip Code

State / Province / Region

Country

Home telephone number

Home fax number

Camper's email *

Previous camp attended

Parents are:

Parent 1 Information

Parent 1 Name

First Name *

Last Name *

Parent 1 home address (if different from camper's)

Street Address

Street Address Line 2

City

Postal / Zip Code

State / Province / Region

Country

Parent 1 occupation

Parent 1 email *

Parent 1 home phone (if different from camper's)

Parent 1 business address

Street Address

Street Address Line 2

City

Postal / Zip Code

State / Province / Region

Country

Parent 1 business phone

Parent 1 fax

Parent 2 Information

Parent 2 Name

First Name

Last Name

Parent 2 home address (if different from camper's)

Street Address

Street Address Line 2

City

Postal / Zip Code

State / Province / Region

Country

Parent 2 occupation

Parent 2 email

Parent 2 business address

Street Address

Street Address Line 2

City

Postal / Zip Code

State / Province / Region

Country

Parent 2 business phone

Parent 2 fax

Additional Information

Please list siblings' names, birthdates and camps they are attending.

I have friends who are interested in Camp Winnebago. Please email information to:

I agree to enroll my son in Camp Winnebago for:

Full 2025 Season: Saturday, June 21 - Monday, August 11, 2025: $16,950
1st Session: Saturday, June 21 - Tuesday, July 15, 2025: $11,450
2nd Session: Wednesday, July 16 - Monday, August 11, 2025: $11,450

Please add any additional comments or questions:

Terms:

It is understood and agreed that campers are enrolled for the entire session and that no reduction will be made for late arrival, absence, or withdrawal, unless the vacancy is filled, except in cases of extended illness, when an equitable and mutually satisfactory adjustment will be made. I/we understand that Camp Winnebago reserves the right to make changes, additions and deletions to its program, activities and personnel.

Camp Winnebago reserves the right to dismiss any camper due to inappropriate behavior including, but not limited to, behavior which is consistently disruptive to his peers and/or the general community, the use of tobacco, alcohol, or non-medically authorized drugs, or any other reason that in the sole discretion of the Director is not in the best interests of the camp in which case no deduction or return of the fee, or any part thereof, will be made. Winnebago is not responsible for additional costs related to the early camper departure.

I understand that part of the camping experience involves activities and group interactions that come with uncertainties beyond what my child may be used to dealing with. Such risks include uneven terrain, standing and moving water, forested and other areas that may result in wildlife encounters that could result in infections and various insect-transmitted diseases. I am also aware that my child may participate in off-campus activities that involve additional risks. In addition, there are certain unavoidable risks associated with various camp activities. I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk-free and so I have instructed my child on the importance of abiding by the camp’s rules, and my child and I both agree that he or she is familiar with these rules and will obey them.

It is agreed that any dispute or cause of action concerning, relating, arising out of or referring to the subject matter of this contract shall be resolved exclusively by binding arbitration in Kennebec County, Maine according to the then existing commercial rules of the American Arbitration Association and the substantive laws of that state.

In the event I/we cannot be reached in an emergency when my/our son is under Camp Winnebago supervision, I/we hereby give permission to the physician selected by the Camp Director to hospitalize, secure proper treatment for, and to order injections, anesthesia or surgery for my son.

My/our son has permission to participate in all camp programs, camp trips and special outings planned and/or supervised by Camp Winnebago. If consent is needed for a particular activity and I/we are not available, I/we authorize Camp Winnebago to contact the person or persons mentioned as my/our emergency contacts on the medical form. I/we give Camp Winnebago permission to reproduce and publish any photograph, video or other likeness of my/our son for advertising, commercial or other camp purpose.

I/we have read and agree to the above terms.

Payments:

A non-refundable tuition deposit of $5500.00 is due with this application. A second payment of $5500.00 is due February 1. The balance is due by May 1, 2025. Included in tuition are canteen, transportation from and to Portland airport, laundry, linens, health & accident insurance and photographs. For 13 - 15 year olds, there is an extra amount for their out of camp trips. Any outstanding balance will incur interest at the rate of 1.5% per month from 5/1/25 if not received by 5/31/25. Please make checks payable to “Camp Winnebago” and return to:

CAMP WINNEBAGO
131 Ocean Street
South Portland, ME 04106
Tel.(800) 932-1646; (207) 767-1019
Fax: (207) 767-1018

I have read and agree to the terms *

Agree

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