Registration Form
This application cannot be submitted online. Please do one of the following:
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PRINT this web page, fill out by hand and MAIL it in.
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For a Word Doc Application that you can TYPE your info into, PRINT and MAIL in, click this link RegistrationApplication2012e-form.doc
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For a pdf document that you can PRINT, fill out by hand and MAIL in click this link RegistrationApplication2012.pdf
Applications will be accepted after January 3, 2012 only.
2012 Whistler, BC Canada
Applicant Name(s):
(Please attach a separate sheet if you are registering for more than 2 people)
Applicant 1: ________________________________________
A.M.C. Member? (Y/N): ____ Age (if <18yrs):____
Applicant 2: ________________________________________
A.M.C. Member? (Y/N): ____ Age (if <18yrs):____
If applying alone, do you have a requested tent partner? (Y/N): ____
If Yes, please list name:_____________________________________
Contact Info:
Street Address:_____________________________________
Apt #:________________
City:____________________________________________
State:__________ Zip Code: ___________________
Home Phone: (________)______________________
Work Phone: (________)______________________
Cell Phone: (________)______________________
E-Mail: _________________________________________________
Choose Your Week(s:)
Please check below the week(s) for which you would like to
register:
_____ Week 1 (July 14 - 21)
_____ Week 2 (July 21- July 28)
_____ Week 3 (July 28- Aug 4)
_____ Week 4 (Aug. 4 - 11)
NOTE: As of 2012, required forms are available only electronically. If you DO NOT have an e-mail address and internet access, then please make arrangements with family or friends to obtain the forms. Libraries are also a good source of computers and info on how to use them.
Payment:
_____ Total Deposit Fee Enclosed, $300 per person
Checks should be made out to "AMC August Camp".
Balance due prior to May 1, 2012. Please send check (NO CREDIT
CARDS) and printed application to:
Trish Niece
810 North Farms Road
Wallingford, CT 06492
NOTE: this application CANNOT be submitted on-line! Please do NOT send by any means that requires a confirmatory signature, such as registered-return receipt mail – this will actually delay receipt of your form.
Registration is first come first served. In the case of oversubscription to a specific week you will be notified.
