Camp Schuylkill 2024: Ages 10 to 12 Registration "*" indicates required fields Child's Name:* First Last Date of Birth:* Month Day Year Grade in September 2024:* Select camp weeks:*Weeks that have reached capacity for this group will no longer appear on the list below. Please contact bkelly@schuylkillcenter.org to be placed on a waiting list for weeks not listed. July 1 to 3 July 8 to 12 Parent/Guardian Name:* First Last Your Phone:*Please enter the best number to reach you for follow-up if needed.Your Email Address:*We will communicate important information and required forms via email to complete registration. Home Address:* Street Address City State / Province / Region ZIP / Postal Code Would you like to include another parent/guardian's contact information?* Yes No Second Guardian Name* First Last Second Guardian Phone:*Second Guardian Email:* Are you Schuylkill Center members?* yes no June 17 to 21* Pay in full: $585.00 Pay 50% deposit: $292.50 June 24 to 28* Pay in full: $585.00 Pay 50% deposit: $292.50 July 1 to 3* Pay in full: $370.00 Pay 50% deposit: $185.00 July 8 to 12* Pay in full: $585.00 Pay 50% deposit: $292.50 July 15 to 19* Pay in full: $585.00 Pay 50% deposit: $292.50 July 22 to 26* Pay in full: $585.00 Pay 50% deposit: $292.50 July 29 to August 2* Pay in full: $585.00 Pay 50% deposit: $292.50 August 5 to 9* Pay in full: $585.00 Pay 50% deposit: $292.50 August 12 to 16* Pay in full: $585.00 Pay 50% deposit: $292.50 Would you like to add before care and/or after care for any camp weeks you have selected?*Before and after-care fees will be prorated for weeks with overnight camping. before care after care none Please select the weeks to attend before care:*Before-care fees will be charged to your account on April 12. June 17 to 21 June 24 to 28 July 1 to 5 July 8 to 12 July 15 to 19 July 22 to 26 July 29 to August 2 August 5 to 9 August 12 to 16 Please select the weeks to attend after care:*After-care fees will be charged to your account on April 12. June 17 to 21 June 24 to 28 July 1 to 5 July 8 to 12 July 15 to 19 July 22 to 26 July 29 to August 2 August 5 to 9 August 12 to 16 Total Coupon Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Billing Address* Same as home address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country How did you hear about Schuylkill Camp? word of mouth Schuylkill Center email Nature Preschool social media news source other What news source, please? 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