Online Application

Camper First Name Camper Last Name Nickname

Date of Birth

Parents' First Name Parents' Last Name

Mailing Address

City State Zip

Email

Home Phone Business Phone Fax Mobile Phone

Please Complete if a Second Parent or Guardian needs to be Added:

Parents' First Name Parents' Last Name

Mailing Address

City State Zip

Email

Home Phone Business Phone Fax Mobile Phone

Please list contacts other than parents and guardians

Name Relationship

Home Phone Work Phone

School Attending Grade Entering in Fall 2008 Church Preference

Height Weight T-Shirt Size

Attended Ton-A-Wandah Before? Yes No If yes, how many terms?

If returning camper: What tribe? Mohawk (Red) Cherokee (Blue) Navajo (Purple)

What cabin assigned in 2007?

New Campers: How did you become interested in Ton-A-Wandah?
Name of Friend:
Advertisement (Name of Publication):
Internet (Name of Website):
Other (Please specify):

Please indicate if your daughter would like to take daily riding: Yes No ($375 additional fee due with completed application)

Does your daughter want to come to camp?

Has she been a camper elsewhere? When? Where?

Does she have brothers? (names and ages)

Does she have sisters? (names and ages)

Does your daughter meet people easily?

What is your daughter looking forward to most in her camping experience?

Does she have any learning, physical, or emotional skills that we should be aware of? If so, please give a brief explanation:

What activities at camp should be avoided?

Will your daughter need special medication? If so, what?

Is your daughter allergic to any medications, food, etc.? If so, what?

Will your daughter need a special diet? If so, what?

Does your daughter swim? Yes No

Does your daughter have one special friend in the same grade with whom she would like to share a cabin? (See information regarding cabin requests.)

Please indicate any special needs (bed wetting, traumatic changes: i.e. new location, school, separation, death in family) or medical conditions of which we need to be aware in preparing for the care of your child. Any suggestions that will be helpful to the staff members in giving your daughter a happy, worthwhile camping experience are greatly appreciated.

1. Name Address

   City State Zip Year Tribe

   Relationship to Camper

2. Name Address

   City State Zip Year Tribe

   Relationship to Camper

I would like to recommend to Ton-A-Wandah

1. Name Address

   City State Zip Email

   Daughter's Name Daughter's Age

2. Name Address

   City State Zip Email

   Daughter's Name Daughter's Age

A deposit of $400 is due with application. How will you be paying (check or credit card)?

You have three payment options:
• Deposit Only
• Deposit and scheduled payments
• Full Tuition (includes deposit)

We will be paying for (please type in one of the options above):

I give Camp Ton-A-Wandah permission to use in its catalogue or on its website any camp picture in which the likeness of my daughter appears. Also, I hereby give permission to the physician selected by the Camp Administrator to hospitalize, secure proper treatment for, and to order injections, anesthesia and surgery as needed for my child named above.

I understand that there are a number of inherent risks involved in summer camp activities. I, my spouse, my child, and my heirs, successors, assigns and personal representatives, hereby release and discharge Camp Ton-A-Wandah, their representative agents, employees, officers, directors, volunteers and successors and assigns (hereinafter referred to individually or collectively as "Releasees") from any liability or causes of action whatever rising from, or on account of, property damage, economic loss, personal injury or death, related to my child's participation in the camp, including, without limitation, any liability or causes of action based on, asserting, or cause by the negligence of Releasees or other persons.

There will be no reduction of fees for late arrivals or early withdrawals, including homesickness. Only in cases of early withdrawal due to serious illness will a refund be considered. The right is reserved to dismiss any girl whose presence, in the Director’s judgment, is detrimental to the best interest of the camp, and in such case there will be no reduction in reservation fee. If cancellation is made on or before February 1, $200 of the $400 reservation will be refunded upon written notification to the camp office. After this date, the entire reservation fee will be forfeited. Cancellation on or after the 14th day before opening day of camp will result in a forfeit of the entire tuition.

I have read and agree with the terms of enrollment as stated with this application.

Signature (parent or guardian) Type your name.