Camp Mont Shenandoah Family Portal

'Camper' Information

Camper First name*
Camper Middle name
Camper Last name*
Lives with
School*
Birthdate*
1. Month
2. Day
3. Year
Grade*
As of September 2021
Home Phone

Address Line 1*
Address Line 2
City*
Country*
State*
State*
Zip Code*

Age on June 25, 2022 in Years and Months

Are there any special needs about which we should be aware?

List the Name of one camper your daughter would like to be placed with in a cabin, if she has a preference. Please note that we attempt to accommodate all requests but do place campers in cabins according to age.

Camper Preferred Name

Gender

How did you hear about Camp Mont Shenandoah?

Is your daughter a legacy (mother, grandmother, aunt or sister attended CMS)? If yes, who is the relative and was she a Green or a Buff?

Please give a brief description of why you are choosing Mont Shenandoah for your daughter. What do you hope will gain from her camping experience with us?

Please note that if you pay by credit card there will be a 3% convenience fee added to your total at check out for amounts greater than $165. For amounts less than $165, there will be a fee of $4.95. You may also either pay via e-check with a $2.95 fee or send a check to the camp office.

Choose Session(s)

Pay deposit for EACH session and EACH camper

Name	Start Date	End Date	Cost	Deposit Required
2022 1st 3 Weeks	06/25/2022	07/16/2022	$0.00 inc. 0.00% tax	$0.00
2022 2nd 3 Weeks	07/17/2022	08/06/2022	$0.00 inc. 0.00% tax	$0.00
2022 2nd session week 1			$0.00 inc. 0.00% tax	$0.00
2022 6 Weeks	06/25/2022	08/06/2022	$0.00 inc. 0.00% tax	$0.00
2022 JC 6 Weeks	06/25/2022	08/06/2022	$0.00 inc. 0.00% tax	$0.00
2022 Roots and Shoots	08/07/2022	08/13/2022	$0.00 inc. 0.00% tax	$0.00

I accept Camp Mont Shenandoah's Terms of Service

I accept Bunk1's

I agree to remit payment for session indicated on the reverse side of this form. I look forward to my daughter participating in all activities and programs offered by Camp Mont Shenandoah (with exception of limitations/restrictions outlined on health form). In addition, Camp Mont Shenandoah may use photographs of my daughter for promotional purposes.

Submit

Camp Registration 2022

'Camper' Information

Choose Session(s)

'Parent 1' Information Copy contact information from 'Camper'

'Parent 2' Information Copy contact information from 'Camper'

Thanks for your submission.