Camper Application | Camp Medolark

Choose one(required)

First Session(4 Weeks) – $7500 – Friday June 23rd to Wednesday July 19th Second Session(3 Weeks) – $5700 – Friday July 21st to Wednesday August 9th (*Limited availability, please call for info.) 2C (2 Weeks)Session – $4400 – Friday July 21st to Thursday August 3rd (*Limited availability, please call for info.) Six Week Session – $11000 – Friday June 23rd to Thursday August 3rd Seven Week session – $11500 – Friday June 23rd to Wednesday August 9th

For the following required medical questions type NONE in the fields if no medication is being taken.

Medications Taken:(required)

Time(s) of day meds are taken:(required)

Other Medical Information:

T-Shirt Size (adult)(required)

Small Medium Large Extra Large

Name(s) and Age(s) of sibling(s):

Previous Camps Attended:

How did you hear about Medolark Camp?(required)

Horseback Riding Lessons

2 weeks $650 4 weeks $1300

Whitewater Rafting

$125 per trip

Any behavioral or social problems at home, school, or a past camp that we ought to be aware of?

Special Food Requirements:

By submitting this online registration, I understand and agree to all Camp Med-O-Lark policies terms, and conditions of enrollment, including the following: A $750 deposit must accompany this registration form to guarantee a space for a camper. The balance of all fees is to be paid in full by May 1, before the camp season starts. Any enrollment after May 1st requires payment in full.

Camp tuition does not include the cost of transportation to camp. The camp reserves the right to dismiss disruptive or abusive campers or campers who show signs of physical or emotional difficulties that the camp does not feel capable of supervising. There will be no refunds issued for early departure related to disciplinary problems. There may be a proportionate refund of payment for cancellation or early departure of campers with medical or family emergencies. There will be no refunds due to homesickness departures.

I hereby authorize any physician selected by the camp director to order x-rays, routine tests, and other medical treatment needed for the health of my child. In the event that I cannot be reached in an emergency, I give permission to the physician s elected by the camp director to hospitalize, secure proper treatment, and to order injections, anesthesia, and/or surgery for my child.

It is agreed that any dispute or cause of action arising between the parties, whether out of this agreement or otherwise, can only be brought in a court of competent jurisdiction located in Knox County, Maine, and shall be construed in accordance with the laws of Maine.

Permission is granted to Camp Med-O-Lark, with no additional charge, for the use of photographs and/or video tapes of campers for promotional purposes or camp mailings after the camp season ends.

I give the camp permission to print our family’s contact information for a listing at the end of the summer to be given to all camp participants. I also give permission for my name and contact information to be given to other camper families.

Note: This information may be shared with the camper’s counselors and/or camp nurses and otherwise is considered confidential.

For payments by check, please promptly mail it to the camp office once you have completed the application.

Choose one

I will mail a check I will pay by credit card

Camp Med-O-Lark does not share any information with any other individuals or companies. Information you provide is not given or sold to any individuals or companies.

A 10% discount is given to each additional camper from the same immediate family.

Cancellations made prior to May 1st will be refunded less the $750 deposit. No refunds will be issued after May 1st.

Camp Med-O-Lark reserves the right to dismiss any camper whose conduct and/or behavior is detrimental to Camp. No refunds will be issued in the event of an early dismissal due to misconduct. Camp Med-O-Lark operates with the highest possible safety standards. However we cannot assume liability for accidents, illness or disease. In case of accidents or sickness, Camp Med-O-Lark is authorized to secure medical attention for the camper named below as is deemed necessary.

By clicking on the Submit Field you are agreeing that you have read the policies above and agree with the conditions stated and have provided your signature.