SERENDIPITY DAY CAMP APPLICATION FORM


Summer 2019


Required fields are marked with an asterisk (*).


NOTE: The form below is for use both by families with a child/children who will attend Serendipity Day Camp as campers, and also by those with a child wishing to parcipate in the Marilou Allen Leadership Program.


Marilou Allen Leadership Program

The Marilou Allen Leadership Program is designed for young people, ages 13 to 14, looking to maintain a connection to camp and prepare for future opportunities to be camp counselors. Running parallel to traditional Serendipity Day Camp, the Leadership Program will be in session from June 17 to August 1 (no camp on July 4th) and is staffed by Senior Counselors from Haverford and other colleges (many of whom are former campers themselves) as well as Junior Counselors from the local community. Marilou Allen Fellows will have the opportunity to learn what it takes to run Serendipity Day camp, while continuing to participate in traditional camp activities such as field trips and all camp events. The Leadership Program and Serendipity Camp are in session from 9:00 am - 3:00 pm with Extended Day hours running to 4:45 pm. Marilou Allen Leadership Program fees for 2019 are $175.00/week.




PERSONAL INFORMATION
Type of Application*
Please select either "Marilou Allen Leadership Program" or "Camper".
Marilou Allen Leadership Program
Camper
Camper's Last Name*
Camper's First Name*
Camper's Preferred First Name*
Camper's Age on June 14, 2019*
Please be aware, there is limited space available for children of the following ages: 7, 8, 10
Unfortunately, SDC is now full for children of the following ages: 13, 14
Child's grade completed at the close of the 2018 - 2019 school year*
Camper's Gender Identity
If camper attended SDC in 2018, please indicate camper's nest.
Indicate the week(s) the Camper will be attending SDC:* (Weekly camp fees for 2019 are $230.00.)
 
Attending?
Afternoon Extended Day?
(3:00 pm - 4:45 pm)

(The Afternoon Extended Day
fee is $25.00 per week.
)
June 17 - 21
Week 1 is now full for children of the following ages: 13, 14
June 24 - 28
Week 2 is now full for children of the following ages: 8, 13, 14
July 1 - 5 (no camp on Thursday, July 4)
Week 3 is now full for children of the following ages: 13, 14
July 8 - 12
Week 4 is now full for children of the following ages: 12, 13, 14
July 15 - 19
Week 5 is now full for children of the following ages: 8, 12, 13, 14
July 22 - 26
Week 6 is now full for children of the following ages: 13, 14
July 29 - August 1 (camp ends with Drama Night on Thursday)
Week 7 is now full for children of the following ages: 8, 13, 14
PARENT(S)/LEGAL GUARDIAN CONTACT INFORMATION
First Contact:*
Last Name
First Name
What is the relationship to the child/family?
Work Phone Number
Home Phone Number
Cell Phone Number
Email Address
Haverford Employee
Second Contact:
Last Name
First Name
What is the relationship to the child/family?
Work Phone Number
Home Phone Number
Cell Phone Number
Email Address
Haverford Employee
EMERGENCY CONTACTS
Primary Emergency Contact:*
Last Name
First Name
What is the relationship to the child/family?
Work Phone Number
Home Phone Number
Cell Phone Number
Email Address
Alternate Emergency Contact:
Last Name
First Name
What is the relationship to the child/family?
Work Phone Number
Home Phone Number
Cell Phone Number
Email Address