Camp Internet Application For Families


I am enrolling in Camp Internet as a:

New participant Returning Camper
And as a:
Family with student/s

I am enrolling in ONE of the following Camp Internet tracks:

Discover the California Channel Islands (suggested for grades 4-9)

Explore the Ancient Southwest (suggested for grades 5-9)

Resdicover America's Original Promise (suggested for grades 7-12)

Explore the Global Garden (suggested for grades K-12)

Discover the California Backcountry (suggested for grades 4-9)

Explore GIS Mapping ( basic GPS/GIS resources are available to all grades
- this track selection is for a higher ed version for 7-12 graders)

I am also interested in particpiating in (select one or more, no addtl cost):

GPS/GIS mapping studies Earth Sciences Center

Western Art and Literature Digital Photography and Video

Services Ordered
I am ordering the following services and/or products:

Family BASE CAMP Subscription $250yr
(includes basic plus weather and garden kits, backpack, video, book and poster)

Family SUMMIT Subscription $350yr
( includes all of Base Camp level plus a GPS, Digital still camera or Digital video camera - circle which)

I am also ordering the following (tax and handling/shipping incl):

GPS unit/s $120 each
Digital Video Camera/s $120 each
Digital Still Camera/s $120 each

Other

Subscriber Contact Information

Parent's Name/s
Parent Email
Student's Names
Family's Home Address
City State Zip
Home phone
Home fax

Our student/s are at the follow grade level/s :

4 5 6 7 8 9 10 11 12 K-3

We plan to use the program :
During school hours Afterschool Weekends

The connectivity to our home computer is:
Our home computer is a PC Mac

Payment Method

Total costs for services and products I am ordering $

I will be paying by credit card MC Visa Am Ex
Card #
Exp Date
Card Holders Name
Card Holders Address

I will be paying by check with signed application - Check #

Agreement

This enrollment agreement includes opportunties for online programs and materials. By enrolling, I agree to pay the program package costs and will be responsible for any elective travel costs. Our family will observe the Camp Internet Acceptable Use Policy and participate as fully a possible.

Please print, CLICK ON SUBMIT, sign this application and mail a copy to

Camp Internet
1129 State Street A7
Santa Barbara CA 93101
(if you decide later to make changes on this form, do so by hand and send in with signature)

Signature
Date
Thanks for Enrolling!
Questions? Call 1-800-889-2823, or email explore@campinternet.net