Archdiocese of Philadelphia

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Camp Overbrook: In Sign 2020

A summer camp for Deaf/Hard of Hearing children that provides a means for summer learning, a sense of Catholic community and an atmosphere which is safe, exciting, educational and fun. Directing the camp are educators who are fluent in American Sign Language.

Qty

Description

Amount

Total

First Child

$85.00

Add’l. Children/Same Family

$50.00

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Total: $85.00

PLEASE LIST FULL NAME FOR EACH CHILD REGISTERED

Child #1 First Name: *

Last Name: *

Date of Birth: *

mm/dd/yyyy

Age: *

T-Shirt Size: *

Gender: *

School: *

Grade: *

County: *

School District: *

Parent/Guardian First Name: *

Parent/Guardian Last Name: *

Home Phone:

Work Phone:

Cell Phone:

Video Phone:

Email: *

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Click Mailing Address below if your child's camp forms should be sent to an address other than the billing address.

Click Child(ren) Summer Address below if your child resides at a different address from the billing address during the dates of camp.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *