Camp Subiaco

405 N. Subiaco Avenue
Subiaco, Arkansas 72865
Telephone:(479)934-1001
Email: campdirector@campsubiaco.org

Camper's Application

Please fill out one form per camper

I wish to register my son for camp session:

* Select A Session: Select One... Week 1:June 13-19, 2010 Week 2:June 20-26, 2010 *

* T-Shirt Size: Select One... Child Small Child Medium Child Large Adult Small Adult Medium Adult Large *

Basic Instructions
Please use upper and lower case letters and turn "CAPS LOCK" off. A red asterisks or red block indicates a required field in order to submit your application.

Camper's Information:
* Last Name: A value is required.
* First Name: A value is required.

* Home Address: *
* City: * * State Select One... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * 
* Zip :   A value is required.

Our camper has the same home address as the Parent or Guardian:

* Age At Camp Time: * 9 10 11 12 13 * * Birth Date: Invalid format.MM/DD/YYYY

Religious Preference:

Camper's Experience: Select One... First Timer Returning Camper

Name of School Attending:

* Grade Level Select One... 4 5 6 7 8 Please select an item.

My brother will be attending camp and his name is:  

If you are the guardian of the camper then place your name in the Father or Mother name space below.

Father's Name:
* Last Name: *
* First Name: *
Subiaco Alumnus?
Class of:

Mother's Name:
* Last Name: *
* First Name: *

Pick only one option:
Our camper lives with both parents:
Our camper lives only with one parent:
Our camper lives with a guardian:

Contact Information:

(Enter same phone number in each field if only one exist)

* Home Phone: A value is required.

* Work Phone: A value is required.

* Cell Phone: A value is required.

* Email Address: A value is required.

Drop-Off/Pick-Up Information:

Please let us know if the Parent/Guardian will be dropping off and picking up the camper by checking the box below. If there will be some one else dropping off or picking up your camper then please provide the name of the responsible adult the space provided.

* Drop-Off by: Parent/Guardian   Other:
* Pick-up by:  Parent/Guardian   Other:

Roommate Request:

In the space provided below please provide the first and last name of the camper your son wishes to be a roommate with. Please understand that we will make an effort to accomodate your request.

*Not guaranteed and based on space availability - Providing more than one name would improve the selection process.

General Information:

1. The Camp Subiaco fee for one week of camp is $425 dollars. We offer a 10% discount for brothers attending camp together (cost for both would be $765). This camp is for boarders only. A minimum deposit of $100 dollars per camper per week (non-refundable) must be submitted with this application.

2. If you are paying by check then print a copy of this registration form and mail a check with this form to the Camp Subiaco address listed above. Please make your check payable to "Camp Subiaco", and do not send cash!

3. If you are paying online by credit card then submit this registration form by pressing the "Submit App" button below, then use the back arrow on your browser to come back to this form and submit your payment online through our secure credit card payment service by pressing the "Pay Online" button below.

4. Your camper's camp reservation is confirmed when we have received a completed registration form and the camp deposit fee.

5. After completing this registration form you will need to fill out the camper Medical History Form. The Medical History Form should be filled out and submitted online. A link to the medical history form is available below.

• WEEK 1: Registration is on Sunday, June 13, 2010, from 1 p.m. until 5 p.m.; Campers should be picked up on Saturday, June 19 at noon.


• WEEK 2: Registration is on Sunday June 20, 2010, from 1 p.m. until 5 p.m.; Campers should be picked up on Saturday, June 26 at noon.

Parents are invited to attend the Mass and Talent Show held each Saturday morning starting at 9 a.m.

To Register for Camp:

Step 1: Submit the Application online by selecting the "Submit App" button below. If you have more than one camper attending camp then fill out and submit an application for each camper.

Step 2: Print a copy of the application by selecting the "Print App" button belowafter you have submitted your application in Step 1. Save a copy of the application for your records and bring it to the first day of camp registration.

Step 3: Pay camp fees or deposit fee by credit/debit card online by selecting the " Pay Online" button below or send a check with a printed copy of your application to our camp office address listed at the top of the form.

Step 4: Fill-out the camper Medical History Form by selecting the "Medical Form" button below and submit it online.

Copyright ©Camp Subiaco 2009-2010