2018 Summer Camp Registration Form

Please fill out the information below. You will be informed within the form if we have reached our limit for your selected week and you will be placed on the wait list.  Wait lists are updated regularly to inform those on the list if their position has increased. 










Please make sure the e-mail you entered above is correct - all communications about camp, invoices, and other information will be sent to this address.  If this address is incorrect, you will not receive the appropriate information needed to ensure your child is set for camp.






A NON-REFUNDABLE* deposit of 50% of your expected cost is due after registering for camp. 
This deposit guarantees your child's spot at camp or holds your child's position on the wait list if they are placed on a wait list.

An invoice will be sent to your e-mail you used to register.  This invoice can be paid by credit/debit card via the invoice or you can send a check to the address below:

PMBC Summer Camp 2018
191 Clifton Beach Rd
Clifton Twp, PA 18424

*Deposits for individuals who cancel at least 30 days before the first day of their scheduled week of camp will be returned. Deposits for individuals placed on a wait list and do not have a spot opened for them will have their deposit returned.


1st Choice 2nd Choice 3rd Choice
Roommate Preference, if any. (We cannot guarantee all preferences will be honored.

Health and Medical Information





Please list any medical conditions and/or restrictions.
If there are no pertinent medical conditions or restrictions, please write "None".






PMBC is not equipped to handle children with severe disabilities. We reserve the right to refuse admittance to anyone we may not be adequately equipped to serve at PMBC. We greatly appreciate your understanding.

Name of Allergy Reaction Intervention
Allergy
Allergy
Allergy
Allergy
Allergy

Please Note: All medications must be turned in to the nurse at registration in the original bottles. Campers can not keep medications in their bags or dispense their own medication or have medication pre-dispensed into pill boxes. 
Name of Medication Dosage Frequency
Med
Med
Med
Med
Med





We must have a copy of your insurance card for local hospitalization treatment. If you are having difficulty uploading the image, please e-mail it to the director at director@camppmbc.com. Thank you!
Photo Release

Any photos or videos placed online will not contain names or identifying information unless specific permission is obtained to do so. Please consider allowing this so that your teen's experience here at PMBC can be documented and others will have the chance to glimpse what happens here at PMBC. 
Discounts




Your discounts will be calculated based on the information you provided above. If you would like to know ahead of time what discounts have been applied and the exact amount you will owe per child, please e-mail the director at director@camppmbc.com. All first time campers are free. A $10 discount will be applied to each registration received before May 1st.

If you have a gift certificate for a full week of camp, the child benefiting from that certificate will not be included in the count of paying campers used to determine the discount structure.

Campers returning for a second week of camp with siblings will need to choose either the second week camping discount applied to all family members or the sibling discount structure applied to all family members

Basic family discount structure is as follows:

First Paying Child - No Discount   

Second Paying Child - $50 discount   

Third Paying Child - $100 discount   

Fourth Paying Child (or more) - $150 discount 


By clicking the submit button below, I testify that I have answered the questions above truthfully and that I understand and agree to the following. I understand that in the event of an emergency, every attempt will be made to contact the parent/guardian. In the event that the parent can not be reached, I understand that PMBC will call 911 if needed to transport my child to the emergency room of the nearest hospital.