EcoVentures | Program Registration

EcoVentures

1901 New Jersey Ave, North Wildwood, NJ 08260

Phone: 609.742.5656

Email: info@EcoVenturesUS.com

GENERAL INFORMATION | LOCATIONS | FREQUENTLY ASKED QUESTIONS | CAMP REGISTRATION

ECOVENTURES ADVENTURE PROGRAMS

REGISTRATION FORM

*=Required

*Parent's First Name:	*Parent's Last Name:

*Billing Address:

*City:	*State:	*Zip:

*Mobile Number (no dashes or spaces):	*E-mail Address:

Please enter the first and last name for each child attending EcoVentures:

(1st Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending1').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending2').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending3').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

Add Child

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending4').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

Add Child

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending5').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

Add Child

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending6').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

Add Child

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending7').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

Add Child

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending8').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

Add Child

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending9').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

Add Child

(Additional Child)	*Child's First Name:	*Child's Last Name:	*Age:	*Dates Attending:

				$('#datesattending10').multiDatesPicker({ dateFormat: 'mm/dd/y', maxPicks: 5 });

I want to purchase an EcoVentures Adventure T-Shirt* ($12/shirt): Yes No

I want to purchase an EcoVentures Backpack/Water Bottle Pack* Yes No

($8 with T-Shirt purchase, $10 if purchased separately)

*You will receive your t-shirt backpack/water bottle combo on the first day of programs

* Add Lunch Option Yes No

For This Child?

(We Provide a cheese

Pizza Lunch for $3/day)

CAMP REGISTRATION FEES:

1 DAY: $69

2 DAYS: $135

3 DAYS: $195

4 DAYS: $250

5 DAYS: $295

CAMP REGISTRATION TOTAL: $

T-SHIRT/BACKPACK TOTAL: $

LUNCH TOTAL: $

TOTAL AMOUNT DUE: $

*Method of Payment:

INITIAL HERE:

*I authorize EcoVentures LLC to charge my credit card …OR will pay cash: Yes

*I agree to the photo release policy: Yes No

*I have read and agree to the terms and conditions & cancellation policy of EcoVentures: Yes

SPECIAL NOTES:

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EcoVentures

1901 New Jersey Ave, North Wildwood, NJ 08260

Phone: 609.742.5656

Email: info@EcoVenturesUS.com