2010 KEYSTONE STATE CAMP 2010 KEYSTONE STATE CAMP 2008 KEYSTONE STATE CAMP
2010 KEYSTONE STATE CAMP APPLICATION
Please fill out this form online, click print and mail with check or money order to:
Keystone State Camps, 7 Hemlock Road, Williamsport, PA 17701
Check the camp you wish to attend:
BOYS CAMPS:
McDaniel College, June 22-25
Bloomsburg University, June 27-July 1
Edinboro University, July 11-15
 Bloomsburg University, July 6-10
 Slippery Rock University, July 24-27
Check the camp you wish to attend:
GIRLS CAMPS:
McDaniel College, June 19-June 22
Bloomsburg University, June 20-June24
 Edinboro University, June 26-June 30
Slippery Rock University, July 28-31
Bloomsburg University, July 31-Aug 4

                                                                                                                                                                                                                      BOY OR GIRL COMMUTER CHECK HERE(Camper not sleeping in Dorm)
Last Name: First Name:
Address: City: State: Zip Code:
Home Phone: Cell Phone:
Email Address: Parent's Email:
Grade in SEPT 2010: School in SEPT 2010:
Position: Height: Weight: T-Shirt Size:
Roommate Preference: (only 2 campers per room)

Parental Medical And Insurance Form - Must Be Complete To Be Accepted

I understand that Keystone State Camps  does not carry medical insurance for students, and I hereby certify that my child,,is covered by a personal medical insurance policy that I have in force. Further, I hereby authorize routine medical dispensary care for the above-named student, and I authorize treatment not considered routine to be referred to local physicians and medical facilities at my expense.
Parent Name:Daytime Phone:
Address:City:State:Zip Code:

Medical Insurance Company:
Ins Policy Id #:Group #

Parent's SignatureDate://
(Must Be Signed & Dated)

Edinboro University & Bloomsburg University

Cost:                $415 if paid in full by June 1, 2010

                                    ($440 paying in full after June 1, 2010)

Commuter:        $360 if paid in full by June 1, 2010

                                    ($385 paying in full after June 1, 2010)

McDaniel College & Slippery Rock University

Cost:                  $375 if paid in full by June 1, 2010

                                 ($400 paying in full after June 1, 2010)

Commuter:      $330 if paid in full by June 1, 2010

                                  ($355 paying in full after June 1, 2010)

PERSONAL CHECKS WILL NOT BE ACCEPTED AFTER JUNE 1. Only money orders, cashier's checks or certified checks will be accepted after JUNE 1. A Confirmation & Directions will be mailed in approximately two weeks.

Make check or money order payable to: Keystone State Camps.
Be sure to SIGN the application.

Mail to: Keystone State Camps, 7 Hemlock Road, Williamsport, PA 17701




APPLICATION CHECKLIST

1. Did you select the location and date you will attend?

2. Did you mark the position you play?

3. Did you fill in your height, weight and grade in school in September of 2010?

4. Is the insurance information completed and signed by the parent or guardian?

5. Be sure to enclose your $75 DEPOSIT OR FULL PAYMENT and to sign your check!
Payment: To make a reservation, send at least a $75 non-refundable deposit or full payment with your completed application.