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Camp Huntington Inquiry Form

(download application forms below this line to begin enrollment)

Click here to download our 2009 Camper Application

Camper Information
Name*:
Birthdate*:	(mm/dd/yyyy)
Please indicate your child's disability:
Please add here anything else you would like us to know about your child:
Parent Information (please provide at least one contact)
Mother:
First Name*:
Last Name*:
Home Phone*:
Work Phone:
Cell Phone:
Email Address*:
Father:
First Name*:
Last Name*:
Home Phone*:
Work Phone:
Cell Phone:
Email Address*:
Home Address:
Street*:
City*:
State and/or Country*:
Zip or Postal Code*:
Payment Options
You can reserve a space for your child by submitting an $450 application deposit. Choose one: I'm sending an $450 deposit by check to reserve a space for my child summer 2009! I'll download the application packet here (requires Adobe Acrobat reader) and mail it in with my check. I'll wait to be contacted by your staff before choosing to place a deposit. I will download the application packet (requires Adobe Acrobat reader) and fill it out in the meantime. **Please note that spaces fill up quickly, so reserve your child's space today by sending in your deposit.
When you click "Submit" you will receive a confirmation page with your information and the mailing address for your deposit. Please enclose the slip with your check and mail to: Camp Huntington Bruria Bodek-Falik, Ph.D., Executive Director, Emeritus P.O. Box 368 Woodstock, NY 12498