Massachusetts Summer Camp | Coastal Discoveries

Home

Activities

Camp for Kids

Application

INFORMATION SHEET

Mission

Our Vessel

Crew

On-Line Signup

Sponsorship

FAQ

Photo Album

Directions

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

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

* Required fields
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 21 - 25
	June 28 - July 2
	July 5-July 9 Teens Only
	July 12-16
	July 19-23
	July 26-30 Teens Only
	Aug 2-6
	Aug 9-13
	Aug 16-20
	Aug.23-27
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

I have read and agree to the Privacy Policy *

Spam prevention

Please enter the code shown above and click the 'Submit Form' button. This additional step is required to help protect against message spam.

Enter code above:

New for 2010: Send $50-$100 with the application. You may then make 3 more payments 1-2 months apart. The final payment of no more than $200 will be due on the first day of your child's week of camp.

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

Fishing Charters Newburyport

[Home] [Activities] [Application] [Camp Information] [Mission] [Our Vessel] [Crew] [Contact Us] [FAQ] [Photos] [Directions]

Web Design by KaSondera at www.completewebpagedesign.com

Web page software from completewebpages.com