Camp Kennybrook, Monticello, New York

Camp Kennybrook Staff Application

Please complete the camper registration form below using the "Tab" key or your mouse to move through the fields.

Now accepting registrations for 2011! Camp opens on June 25th, Visiting Day will be July 16th. End of first session/beginning of second session July 19th. Camp will close on August 14th.

Camper Information
Please Enroll My	Daughter Son
First Name
Last Name

Camper's E-mail Address*

Mailing Address
Street/Apt/PO Box
City
State
Zip or Postal Code
Country
Phone

Other Camper Info
Birth Date
Age
Present Grade, as of Sept. 2010
School Presently Attending
Prior Years at Kennybrook

Choose a Program
$5,400 (4 Week Program / 1st Session) $5,300 (4 Week Program / 2nd Session) $8,250 (8 Week Program / Full Summer) $8,950 (Senior Trip)

Parent Information
Father's Name
Business Name
Business Phone #
Cell Phone #

Mother's Name
Business Name
Business Phone #
Cell Phone #

Parent's E-mail Address*

I hereby contract with Camp Kennybrook, Inc. to pay the sum of $5400 for the 2011 camping season. Camp fee is payable as follows: $1500 upon signing of the contract and the balance due on or before April 1, 2011. Fee includes all counselor gratuities, day canteen, laundry, crafts materials, water-skiing, transportation to and from Camp. If, in the judgment of Camp, it is necessary to use outside medical or dental aid for the camper's health and welfare, this gives the authorization to do so. Camp reserves the right to dismiss a camper whose conduct is unsatisfactory and detrimental to the best interests of the camp without a fee rebate. Said fee is non-refundable in the event of early departure from Camp as chosen by the Camp or the parents. Camp may use all photographs and video taken in their promotional materials. Camp Kennybrook is licensed by The New York State Department of Health which inspects the Camp at least twice yearly. Copies of these reports areavailable at the Health Department office in Monticello, New York. I hereby contract with Camp Kennybrook, Inc. to pay the sum of $5300 for the 2011 camping season. Camp fee is payable as follows: $1500 upon signing of the contract and the balance due on or before April 1, 2011. Fee includes all counselor gratuities, day canteen, laundry, crafts materials, water-skiing, transportation to and from Camp. If, in the judgment of Camp, it is necessary to use outside medical or dental aid for the camper's health and welfare, this gives the authorization to do so. Camp reserves the right to dismiss a camper whose conduct is unsatisfactory and detrimental to the best interests of the camp without a fee rebate. Said fee is non-refundable in the event of early departure from Camp as chosen by the Camp or the parents. Camp may use all photographs and video taken in their promotional materials. Camp Kennybrook is licensed by The New York State Department of Health which inspects the Camp at least twice yearly. Copies of these reports areavailable at the Health Department office in Monticello, New York. I hereby contract with Camp Kennybrook, Inc. to pay the sum of $8250 for the 2011 camping season. Camp fee is payable as follows: $1500 upon signing of the contract and the balance due on or before April 1, 2011. Fee includes all counselor gratuities, day canteen, laundry, crafts materials, water-skiing, transportation to and from Camp. If, in the judgment of Camp, it is necessary to use outside medical or dental aid for the camper's health and welfare, this gives the authorization to do so. Camp reserves the right to dismiss a camper whose conduct is unsatisfactory and detrimental to the best interests of the camp without a fee rebate. Said fee is non-refundable in the event of early departure from Camp as chosen by the Camp or the parents. Camp may use all photographs and video taken in their promotional materials. Camp Kennybrook is licensed by The New York State Department of Health which inspects the Camp at least twice yearly. Copies of these reports areavailable at the Health Department office in Monticello, New York. I hereby contract with Camp Kennybrook, Inc. to pay the sum of $8950 for the 2011 camping season. Camp fee is payable as follows: $1500 upon signing of the contract and the balance due on or before April 1, 2011. Fee includes all counselor gratuities, day canteen, laundry, crafts materials, water-skiing, transportation to and from Camp. If, in the judgment of Camp, it is necessary to use outside medical or dental aid for the camper's health and welfare, this gives the authorization to do so. Camp reserves the right to dismiss a camper whose conduct is unsatisfactory and detrimental to the best interests of the camp without a fee rebate. Said fee is non-refundable in the event of early departure from Camp as chosen by the Camp or the parents. Camp may use all photographs and video taken in their promotional materials. Camp Kennybrook is licensed by The New York State Department of Health which inspects the Camp at least twice yearly. Copies of these reports areavailable at the Health Department office in Monticello, New York.
Agreement to terms (Required)

I HEREWITH ENCLOSE THE REGISTRATION FEE OF $1,500 to be credited to my account. Camp fee is refundable in full up to January 1, 2011. After said date, registration fee is non-refundable.

Winter Address
633 Saw Mill River Road
Ardsley, New York 10502
(914) 693-3037 | Fax: (914) 693-7678 (until June 20th)
E-mail: kennybrook@aol.com

Summer Office
PO Box 5014
73 Camp Road
Monticello, New York 12701
(845) 794-5320 | Fax: (845) 791-4738 (after June 20th)
E-mail: kennybrook@aol.com