Massachusetts Summer Camp | Coastal Discoveries

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Contact Coastal Discoveries
This is a Preliminary Sign Up

By filling out this form we will reserve a spot for your camper while we wait for you to send the regular form and your payment.

Coastal Discoveries
55 Hay Street
Newbury, MA 01951
Tel. 978-462-8859 Fax. 978-499-7735

Name *
E-mail Address *
M/F *
Mailing Address:
City:
State:
Zip Code:
Home Phone: *
Emergency telephone #: *
Birth Date: "Must be 9 or older"
Swimming Ability
How many weeks? Note: Teens can attend any week or the "Teen Only" week.
	June 23-27/no space available
	June 30-July 4
	July 7-11/no space available
	July 14-18/ no space available
	July 21-25/no space available
	July 28-Aug 1 "Teens"/no space available
	Aug 4-8 No space available
	Aug 11-15 No space available
	Aug 18-22
	Aug.25-29
Has your child completed the Mass. State Safe Boating Course? *
Do you give your permission for your child to enroll in the Mass. State Safe Boating Course.
Permission for Coastal Discoveries to use Photos, Video of your child or children.
I would like my child to receive a Coastal Discoveries T-Shirt adult sizes: Please add $15 per shirt when sending your deposit.
List any allergies or medications that need to be taken during program hours or any special needs your child may have.
Questions and Comments

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Payment must be received two weeks before camp week to reserve the date for your child.

When sending your reservation money please remember to include $15 for each TShirt.

Print and send the application with your payment please.

Coastal Discoveries
55 Hay Street
Newbury, MA 01951
Tel. 978-462-8859 Fax. 978-499-7735

Captain Bob's Cell Phone 978-815-6160

Lee's Cell Phone 978-479-1632