Marcellus Summer Camp

To apply by mail, complete this form, print and mail it with a check made payable to Mansfield University to the following address:

Marcellus Summer Camp
G1 Alumni Hall
31 South Academy St
Mansfield University
Mansfield, PA 16933

Residential Fee:

$230.00

Commuter Fee:

$190.00

Registration Deadline:

July 5, 2013

A nonrefundable deposit of $75.00 is required at the time of registration

*If you wish to pay by credit card, please fill in the online form.

Camper's Information

*Indicates a required field

*First Name: *Last Name:

*Gender: Male Female      *Age:      *T Shirt Size:

*Camper Status: Resident Commuter

Roommate Request:
(Request must be made by both campers)

School:      Grade in Current School Year:

 

Parent/Card Holder Information:

*Parent Name:

*Street Address:

*City: *State: *Zip Code:

*Email:

Home Phone:

Work Phone: Whose work number?: