Outdoor Adventure Camp 2024 Application Please note: applications are limited to 5 of the 6 weeks of camp due to limited availability. 14 & 15 year olds interested in being a CIT (counselor in training) can apply here too. Participant Child's first name * Child's last name * Birth month * —Please choose an option—JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Birth day * —Please choose an option—01020304050607080910111213141516171819202122232425262728293031 Birth year * —Please choose an option—200820092010201120122013201420152016201720182019 Child's School 2023-2024 * —Please choose an option—Carrabassett Valley AcademyMaine Mountain Children's HouseMSAD 58Stratton SchoolWestern Maine Center for ChildrenHomeschoolOther What school is your child currently attending? Grade next year* —Please choose an option—Kindergarden1st2nd3rd4th5th6th7th8th Grade this child will attend in September, 2024. Medical Info Is there any medical info we should be aware of? Example include, but are not limited to, asthma, allergies, physical restrictions, and current medications. Behavioral Info Is there any behavioral info we should be aware of? Schedule Week 1 July 8, 2024, Monday July 9, 2024, Tuesday July 10, 2024, Wednesday July 11, 2024, Thursday July 12, 2024, Friday Week 2 July 15, 2024, Monday July 16, 2024, Tuesday July 17, 2024, Wednesday July 18, 2024, Thursday July 19, 2024, Friday Week 3 July 22, 2024, Monday July 23, 2024, Tuesday July 24, 2024, Wednesday July 25, 2024, Thursday July 26, 2024, Friday Week 4 July 29, 2024, Monday July 30, 2024, Tuesday July 31, 2024, Wednesday August 1, 2024, Thursday August 2, 2024, Friday Week 5 August 5, 2024, Monday August 6, 2024, Tuesday August 7, 2024, Wednesday August 8, 2024, Thursday August 9, 2024, Friday Week 6 August 12, 2024, Monday August 13, 2024, Tuesday August 14, 2024, Wednesday August 15, 2024, Thursday August 16, 2024, Friday Parent or Legal Gudardian Parent or Legal Guardian's name * Email * Phone number * Mailing Address * Your mailing address including city, state, and zip code. Carrabassett Valley Taxpayer? * —Please choose an option—YesNo Is the parent or legal guardian of the participant a taxpayer in Carrabassett Valley? Taxpayer Address Physical address of the property where the parent/guardian is a Carrabassett Valley taxpayer. Backup Emergency Contacts Backup contact #1 name * Name of backup emergency contact #1. Backup contact #1 phone * Backup contact #2 name Name of backup emergency contact #2. Backup contact #2 phone I give the town of Carrabassett Valley and Outdoor Adventure Camp permission to take videos and photos of my child, and to use the depictions in print and/or online and electronic media. Last Update April 1, 2024