Registration – Campers 2023 – Sebago Leadership Camp

2023 Camper Registration

Camp Dates: June 18 – 24, 2023
Location: Camp H. A. Moses, 310 Birch Hill Rd, Russell, MA 01071

Application Fees

Standard Fee: The standard fee is $650 for first son and $600 for each additional son

Parent / Guardian Information
Name*
First Last
Email*
Cell Phone*
Home Phone
Address*
Street Address City State ZIP Code
How many campers are you registering now?*
- 1
- 2
- 3
Camper Information
Son's Name*
First Last
Hidden
Camper1-Full-Name
Grade in Fall 2023*
School Name*
T-Shirt Size*
Sports
Hobbie's / Interests
Photo of Camper (Optional)
Accepted file types: jpg, png, jpeg, gif, pdf, tiff, bmp, heif, svg, Max. file size: 5 MB.
Please provide a current photo of your son. This helps our counselors greatly (it will NOT be used for any public display). A head shot or any quality photo less than 5MB is fine. Must be in a standard picture format.
Why do you want to attend this camp?*
Pertinent Health Information, including allergies, medications, etc.*
Camper #2 Information
Son's Name*
First Last
Hidden
Camper2-Full-Name
Grade in Fall 2023*
School Name*
T-Shirt Size*
Sports
Hobbies / Other Interests
Photo of Camper
Accepted file types: jpg, png, Max. file size: 2 MB.
A head shot or any quality photo (approx. 300 x 300px) and less than 2MB is fine. Must be in JPG or PNG format.
Why do you want to attend this camp?*
Pertinent Health Information, including allergies, medications, etc.*
Camper #3 Information
Son's Name*
First Last
Hidden
Camper3-Full-Name
Grade in Fall 2023*
School Name*
T-Shirt Size*
Sports
Hobbie's / Interests
Photo of Camper
Accepted file types: jpg, png, Max. file size: 2 MB.
A head shot or any quality photo (approx. 300 x 300px) and less than 2MB is fine. Must be in JPG or PNG format.
Why do you want to attend this camp?*
Pertinent Health Information, including allergies, medications, etc.*
Registration Fee
Camper Fee
Camper #2 Fee
Camper #3 Fee
FEE TOTAL
Deposit Due
Price: $0.00
Additional to pay now

To pay more than the deposit toward the total fee, enter an amount.
Scholarship Donation (optional)

For our Sebago Camp Scholarship Fund for campers in need of financial assistance
Total for Today
$0.00
Amount Due (by Check)
Price: $0.00
Balance Due by May 22
Hidden
Total Due (Hidden)
Waivers
Medical Waiver*

I hereby delegate authority to the Directors of the Sebago Leadership Camp (SLC) to arrange whatever medical treatment they deem necessary for him during his stay at the camp.
Photo Release*

I hereby authorize and consent to the use and reproduction by SLC staff or an authorized agent or assignee of any and all photographs taken of my son for the purpose of promoting SLC without any compensation to me. All film, together with any prints, shall constitute property of SLC, solely and completely.
Participation and Liability Waiver*

I hereby give permission for our son to participate in all activities conducted by SLC. We agree to hold the directors and staff harmless from any liability to anyone on account of any injuries to our son. I understand that SLC cannot be responsible for lost or broken items. I understand my son will comply with all cabin policies and procedures. I also understand, and will comply with, all cancellation policies and procedures.
Payment Method*
- Credit Card
- Pay by Check
Financial Assistance
If you're in need of financial assistance with the registration fee, we offer options for a Payment Plan (pay over time) or Scholarship (reduction in amount). Please choose one below. Then, whatever amount you are able to pay now is fine. Use the Notes box as needed to elaborate on your request.
Request for Assistance
Amount You Can Pay Now

Please enter an amount you feel comfortable paying now. We will then follow up to arrange financial assistance for you.
Notes
Add any relevant notes about your request or circumstances (optional)
TOTAL for Today
$0.00
Hidden
Total - Credit Card and 0
This is a hidden value used only to set as a condition for an email notification. If the value is "0," a specific email and confirmation will be sent. The "Total" product field is not an option for email.
Hidden
Total (email trigger)
Hidden
TOTAL - Fin.Assist/PayPal Trigger
Determines if PayPal should be triggered when Financial Assistance is used. Hidden Field.
NOTE: Upon submission you will be taken to PayPal where you can pay by credit card (but it does NOT require you to have a PayPal account).
NOTE: Upon submission you will go to a page with information on paying by check, and you will receive an email confirmation with the same.
CAPTCHA

2023 Camper Registration

Application Fees

Parent / Guardian Information

Camper Information

Camper #2 Information

Camper #3 Information

Registration Fee

Waivers

Financial Assistance

Camp Address