Camper Information
3 Step Process
1 - Enter Registration
2 - Print and Review
3 - Credit Card Payment
Complete Camper information at top before choosing camp sessions and trips below
* Indicates a required field
Camper's First Name:
*
Camper's Last Name:
*
Date Of Birth:
* (i.e. mm/dd/yyyy)
Entering Grade:
<-Select One->
2
3
4
5
6
7
8
9
10
11
*
Nickname:
Home Address:
*
City:
*
State:
<-Select One->
None
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
ZIP Code:
*
Country:
Primary Email Address:
Primary
Work
Camper
*
Alternate Email:
Primary
Work
Camper
Camp Correspondence to all email addresses
Alternate Email:
Primary
Work
Camper
Primary Phone:
Home
Cell
Business
*
Alternate Phone:
Home
Cell
Business
Alternate Phone:
Home
Cell
Business
Gender
Male
Female
*
Camper Last Year?
Yes
No
How did you hear about Anokijig?
<--Select One-->
ACA
Alumni
Anokijig Web Site
Brochure
Camp Fair
Family Camp
Friend
Gift Certificate
Group
Internet
Magazine
Neighbor
Newspaper
Other
Recommendation
Relative
School
Special Event
TV Ad
YMCA
We will honor one housing request per camper so that two friends in the same age group may stay in the same living section:
Enter only one friend name:
Parent/Legal Guardian Name(s):
Parent (1):
<-Select One->
Mother
Father
Guardian
Other
*
First Name:
*
Last Name:
*
Occupation:
Business Name:
Parent (2):
<-Select One->
Mother
Father
Guardian
Other
First Name:
Last Name:
Occupation:
Business Name:
Session Schedule
Session ID
Begin Date
End Date
Session 1
06/17/2012
06/23/2012
Session 2
06/24/2012
06/30/2012
Session 3
07/01/2012
07/07/2012
Session 4
07/08/2012
07/14/2012
Session 5
07/15/2012
07/21/2012
Session 6
07/22/2012
07/28/2012
Session 7
07/29/2012
08/04/2012
Session 8
08/05/2012
08/11/2012
Session 9
08/12/2012
08/18/2012
Legend
Dash (-)
Activity Not Offered This Session
Call
Call for availability
NQ
Camper does not qualify for activity because of age or grade.
Camp Session Status:
Session
1
6/17-6/23
Session
2
6/24-6/30
Session
3
7/1-7/7
Session
4
7/8-7/14
Session
5
7/15-7/21
Session
6
7/22-7/28
Session
7
7/29-8/4
Session
8
8/5-8/11
Session
9
8/12-8/18
Session Availability:
General Camp Program Options
Select Prices increase May 1, 2012
If you do not see open boxes to check below, go to the top of the page and fill in the Grade and Date of Birth fields.
Activities
Price
Session
1
6/17-6/23
Session
2
6/24-6/30
Session
3
7/1-7/7
Session
4
7/8-7/14
Session
5
7/15-7/21
Session
6
7/22-7/28
Session
7
7/29-8/4
Session
8
8/5-8/11
Session
9
8/12-8/18
Resident Camp
$556.00
Mini Camp
$401.00
Stamper
$330.00
Specialty Camp Options
Select Prices increase May 1, 2012
If you do not see open boxes to check below, go to the top of the page and fill in the Grade and Date of Birth fields.
Activities
Price
Session
1
6/17-6/23
Session
2
6/24-6/30
Session
3
7/1-7/7
Session
4
7/8-7/14
Session
5
7/15-7/21
Session
6
7/22-7/28
Session
7
7/29-8/4
Session
8
8/5-8/11
Session
9
8/12-8/18
Ranch
$612.00
Circle A Riders
$612.00
Competitive Swim
$612.00
-
-
-
-
-
-
-
-
Adventure Challenge
$556.00
-
-
-
-
-
Fishing Expedition I
$644.00
-
-
-
-
-
-
Fishing Expedition II
$644.00
-
-
-
-
-
-
Theater in the Woods
$556.00
-
-
-
-
-
-
-
-
Yoga
$556.00
-
-
-
-
-
-
-
-
Drum, Drum, Drum
$556.00
-
-
-
-
-
-
-
-
Camp Comedy
$556.00
-
-
-
-
-
-
-
-
Week Long Adventure Trips
Select Prices increase May 1, 2012
If you do not see open boxes to check below, go to the top of the page and fill in the Grade and Date of Birth fields.
Activities
Price
Session
1
6/17-6/23
Session
2
6/24-6/30
Session
3
7/1-7/7
Session
4
7/8-7/14
Session
5
7/15-7/21
Session
6
7/22-7/28
Session
7
7/29-8/4
Session
8
8/5-8/11
Session
9
8/12-8/18
Whitewater Week Trip
$612.00
-
-
-
-
-
-
-
Rock, Roll, & Splash
$630.00
-
-
-
-
-
-
-
Mini Flambeau Combo
$612.00
-
-
-
-
-
-
-
-
Sylvania Canoe and Fishing
$608.00
-
-
-
-
-
-
-
-
Apostle Islands
$630.00
-
-
-
-
-
-
-
-
Half-Day
Select Prices increase May 1, 2012
If you do not see open boxes to check below, go to the top of the page and fill in the Grade and Date of Birth fields.
Activities
Price
Session
1
6/17-6/23
Session
2
6/24-6/30
Session
3
7/1-7/7
Session
4
7/8-7/14
Session
5
7/15-7/21
Session
6
7/22-7/28
Session
7
7/29-8/4
Session
8
8/5-8/11
Session
9
8/12-8/18
Day Trip: Caving
$24.00
-
-
-
-
Day Trip: Paint Ball
$85.00
Day Trip: Ropes Course
$40.00
-
-
-
-
-
Day Trip: Go Kart Adven Plus
$72.00
Full-Day
Select Prices increase May 1, 2012
If you do not see open boxes to check below, go to the top of the page and fill in the Grade and Date of Birth fields.
Activities
Price
Session
1
6/17-6/23
Session
2
6/24-6/30
Session
3
7/1-7/7
Session
4
7/8-7/14
Session
5
7/15-7/21
Session
6
7/22-7/28
Session
7
7/29-8/4
Session
8
8/5-8/11
Session
9
8/12-8/18
Day Trip: Go Kart/Paintball Combo
$120.00
-
-
-
-
-
Day Trip: Noah's Ark
$91.00
-
-
-
Day Trip: Whitewater Rafting
$86.00
-
-
-
-
-
Weekend Stay Overs
Price
1 to 2
2 to 3
3 to 4
4 to 5
5 to 6
6 to 7
7 to 8
8 to 9
Carry-Over
$60.00
Bus Transportation To Camp
Pick Up Location
Price
Session
1
Session
2
Session
3
Session
4
Session
5
Session
6
Session
7
Session
8
Session
9
Lake Forest Oasis
$56.00
Gurnee Mills
$43.00
Kenosha
$37.00
Racine Hardees
$37.00
Racine I-94 & Hwy 20
$37.00
Brown Deer & I-43
$34.00
Milwaukee South
$34.00
Madison
$43.00
Columbus
$37.00
Beaver Dam
$37.00
Fond du Lac
$33.00
Bus Transportation To Home
Drop Off Location
Price
Session
1
Session
2
Session
3
Session
4
Session
5
Session
6
Session
7
Session
8
Session
9
Lake Forest Oasis
$56.00
Gurnee Mills
$43.00
Kenosha
$37.00
Racine Hardees
$37.00
Racine I-94 & Hwy 20
$37.00
Brown Deer & I-43
$34.00
Milwaukee South
$34.00
Madison
$43.00
Columbus
$37.00
Beaver Dam
$37.00
Fond du Lac
$33.00
ATTENTION: PARENT OR GUARDIAN
SIGNATURE & DATE REQUIRED
I approve this application and certify that the applicant is capable of such an experience. I agree to pay the balance of the fees and send in all paperwork four weeks prior to arrival to avoid late charges of $25.00. I understand that the deposit is not refundable or transferable. I understand that no refunds are given if a child leaves early because of homesickness or for disruptive behavior as determined by the Camp Director.
Parent/Guardian Name:
*
Date:
*
Please feel free to include any comments you would like to communicate in the space below
(256 character max):
If more information is needed, please send an email to Camp Anokijig:
Anokijig@excel.net
You will be mailed a confirmation letter confirming your spot and containing information to assist you in your planning.
Registration Fees
Camp Session Fees:
Day Trip Fees:
Weekend Stay Fees:
Transportation Fees:
Minimum Deposit:
Minimum. non-refundable deposit is $100.00 per session.
Balance Due:
Trading Post:
Donation:
To pay in full, enter Balance Due in Additional Payment field
Additional Payment:
Total Payment:
Grand Total:
PLEASE VERIFY INFORMATION IS CORRECT