Mount Michael Benedictine

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

PLEASE NOTE: If you need to pay the remaining balance for camp please CLICK HERE.

To learn more about Camp Mount Michael, visit our camp website at: Camp Mount Michael

PLEASE NOTE: Camp Mount Michael lasts from Sundays-Fridays.

QUESTIONS: Please contact Tim Carlson, Camp Director at (402) 238-1457 or camp@mountmichael.org

Each session is $400 per week. A $50 deposit can be paid now and the remaining $350 can be paid at a later date. The entire $400 can be paid at this time if you wish to do so.

In placing my son in your care, I agree to all terms, regulations and activities of Camp Mount Michael. I agree to bear the burden of any expense arising from accident or illness, which is not covered by the camp insurance policy while my son is under the authorities of the camp. I understand that the $50 deposit will be applied towards the total camp fee and is non-refundable even in case of disciplinary action and/or homesickness. Please be aware that each session will cap at 85 campers.

Week 1

Qty

Description

Amount

Total

Week 1: OVERNIGHT 6/23/2024- 6/28/2024

$50.00

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Deposit (Pay $50 now, $350 later)

Week 1: OVERNIGHT 6/23/2024 - 6/28/2024

$400.00

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Full Payment (Already Includes Deposit)

Week 1: DAY CAMP 6/23/2024-6/28/2024

$350.00

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This is a day camp option, only available Week 1. Drop off will be at 8:00 am M-F and pickup will be at 4:30 pm. *Spots Limited to 20* Full Payment (Already Includes Deposit)

Week 2

Qty

Description

Amount

Total

Week 2: 7/7/2024 - 7/12/2024

$50.00

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Deposit (Pay $50 now, $350 later)

Week 2: 7/7/2024 - 7/12/2024

$400.00

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Full Payment (Already Includes Deposit)

Week 3

Qty

Description

Amount

Total

Week 3: 7/14/2024 - 7/19/2024

$50.00

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Deposit (Pay $50 now, $350 later)

Week 3: 7/14/2024- 7/19/2024

$400.00

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Full Payment (Already Includes Deposit)

Week 4

*Please note that spots are reserved in Week 4 for the incoming freshman class to Mount Michael Benedictine. Therefore, the average age of campers this week will be older than the previous 3 weeks*

Qty

Description

Amount

Total

Week 4: 7/21/2024 - 7/26/2024

$50.00

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Deposit (Pay $50 now, $350 later)

Week 4: 7/21/2024 - 7/26/2024

$400.00

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Full Payment (Already Includes Deposit)

Week 4: 7/21/2024 - 7/26/2024

$300.00

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Incoming Member of the Class of 2028 Only: Full Payment (Already Includes Deposit)

DISCOUNT CODE

Discount Code

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Total: $0.00

Camper Information

Camper Name #1: *

Date of Birth: *

Age: *

Grade (in Fall): *

School Attending in Fall of 2024 *

# of Years at Camp Mount Michael:

T-Shirt Size: *

Please put my son in the same group as:

Health History:

Medical Problems:

Allergies:

Date of Last Tetanus Shot:

Operations of other serious illness:

Is your child on medications, if so what kind:

Medications Bringing To Camp:

Consent to Treat Release: *

The health history is correct to the best of my knowledge and the person described herein has permission to engage all prescribed camp activities except noted by me. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the Camp Director to hospitalize, secure proper treatment, and to order injection, anesthesia or surgery for my child as named above.

I understand that the purpose of this is to totally relieve Camp Mount Michael and its owners, agents, and employees from any and all liability for injuries, deaths or loss of property sustained by me or by my child by any person in my charge as a result of participation in a Camp Mount Michael activity.

I agree to all terms: *

In placing my son in your care, I agree to all terms, regulations and activities of Camp Mount Michael. I agree to bear the burden of any expense arising from accident or illness, which is not covered by the camp insurance policy while my son is under the authorities of the camp.

Parent Information:

Parent/Guardian: *

Address: *

Address 2:

City: *

State: *

Zip Code: *

Home Phone: *

Cell Phone:

Business Phone:

Email:

Please note: Events arise where Mount Michael campers may be photographed or recorded for television, newspaper, web-site, or radio coverage. If the parents object to this they must notify the camp director in writing prior to the beginning of their child’s camp session.

Emergency Information

Emergency Contact #1: *

Home Phone: *

Cell Phone: *

Work Phone: *

Emergency Contact #2: *

Home Phone: *

Cell Phone: *

Work Phone: *

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.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *