Register for Rookie Day!

Name: Camp Walt Whitman
Address: 1000 Cape Moonshine Road, Piermont, New Hampshire, 03779, US
Telephone: 1-800-657-8282
Price range: $6,950 - $13,350

Date I would like to enroll my child on for Rookie Day*
Camper's Name*
First Last
Date of Birth*
Month
Day
Year
Grade entering in September 2020*
Current School*
Current Day Camp
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
T-Shirt Size*
Parent 1 Name*
First Last
Parent 1 Cell*
Parent 1 Email*
Parent 2 Name
First Last
Parent 2 Cell
Parent 2 Email
Emergency Contact*
First Last
Emergency Contact Cell*
Does your child have any sensitivities or fears?*
- Yes
- No
If yes, please describe your child's sensitivities or fears*
Does your child require any special dietary or medical needs?*
- Yes
- No
If yes, pleased describe your child's special dietary or medical needs*
Is there anything else about your child you would like to share with us?*
- Yes
- No
Please add any additional info about your child you feel we should know*
How did you hear about Camp Walt Whitman?*