Application

Instruction Sheet Important – Please Read Carefully!

There is a $40 non-refundable application fee that MUST accompany each application.
Checks should be made out to the Lake Delaware Boys’ Camp.

The application WILL NOT be considered if it is not COMPLETELY filled out. Please furnish us with ALL the information requested before returning it to our office. If you have any questions or need assistance, please contact the office at the above address or phone number.

Places at camp will be filled shortly after the due date, and applications received after April 15th cannot be guaranteed a place. You should hear by May 15th, whether your son has been admitted for the camp season. If your son has been admitted, you will then receive the necessary information and forms needed to attend LDBC.

Since 1909, there has been no required charge for a boy to attend LDBC. Because each boy who attends LDBC will receive an unique summer camp experience unlike that of other camps, all families are encouraged to make a donation to LDBC that is within their means. Based on our annual expenses, the cost to LDBC for each camper is currently $3,500 per season. Although ALL parents are encouraged to make a donation, donations in any amount are greatly appreciated and no boy will be denied admission because of an inability to pay. As the continued operation of Camp depends on your support, we ask that you be as generous as possible. Donations should be made by June 15th, but should not be sent until you have received a letter informing you that your son has been accepted to attend camp this summer.

You may fill out the form below and pay the application fee online or download this PDF 2017-camp-application to mail in.

*If you do not know information about the Mother or Father, enter “Unknown” in those fields.

Applicant Information

Applicant's Full Name*
Applicant's Address*
Applicant's Address 2
Applicant's City*
Applicant's State*
Applicant's Zip*
Applicant's Phone*
Applicant's Email*
Applicant's Height*
Applicant's Weight*
Applicant's Date of Birth*
Photo of Applicant* (Note: There is an 8mb file size limit)

Father's Information

Father's Full Name*
Father's Address*
Father's Address 2
Father's City*
Father's State*
Father's Zip*
Father's Phone*
Father's Email*
Father's Occupation and Employer's Name*
Father's Employer's Address*
Father's Employer's Address 2
Father's Employer's City*
Father's Employer's State*
Father's Employer's Zip*
Father's Employer's Phone*

Mother's Information

Mother's Full Name*
Mother's Address*
Mother's Address 2
Mother's City*
Mother's State*
Mother's Zip*
Mother's Phone*
Mother's Email*
Mother's Occupation and Employer's Name*
Mother's Employer's Address*
Mother's Employer's Address 2
Mother's Employer's City*
Mother's Employer's State*
Mother's Employer's Zip*
Mother's Employer's Phone*

Miscellaneous Information

Other members of household & relationship to applicant:
Has this boy been baptised? Is so, what was the date?
Has this boy been confirmed? Is so, what was the date?
Grade*
Average*
I give permission for my son’s school to be contacted for any further information.
Is this child currently in an individualized education plan (IEP) as part of his school programming? If yes, please explain.
To what church does he belong (include name and phone number of priest and address of church)?
Has this boy received any awards or special recognition in school, church or scouts, in the past year (please explain)?
Please tell us of any behavioral problems your son may have experienced.
Has this boy been under any type of medical care in the past year (sickness, accidents, operations, under care of a therapist (please explain)?
Who recommended LDBC to you (name, address, phone# and relationship to you and to LDBC (be specific)?
Any additional comments (i.e.: sports, hobbies, special interests, musical instruments, etc.):
Your Relationship to Applicant*
By checking this box I certify that I agree to the above terms.
**Please be patient while your photo uploads to our server. You will be redirected to payment after the photo finishes uploading. Consider reducing the size of your photo if the upload is taking too long.

Application & Consent Terms

I hereby certify that all information provided is correct.

I consent that while at Camp he will attend the religious services provided.

I further consent that he may be given whatever medical tests, care or treatment that may be prescribed by the physician or nurse selected by Camp; that he may undergo any emergency operation deemed necessary by such physician or nurse.

I hereby entrust the care and supervision of him to Camp upon his arrival July 8th, 2015 until his departure on August 9th, 2015. It is understood and agreed that Camp and its counselors and employees may use such disciplinary measures as are proper under New York State law as may be reasonably necessary to maintain discipline or to promote his welfare.

In consideration of permitting my son/ward to participate in all Camp activities and Camp trips, I release and discharge Lake Delaware Boys’ Camp, Lake Delaware Alumni Association and their respective Board of Directors and Officers, their employees, chaperones and volunteers in connection with Camp activities and/or trips.

I hereby authorize Lake Delaware Boys’ Camp to use my son’s likeness in any photographs, videos, or other promotional activity, including on the Camp website.

I have authority to give this release and consent and acknowledge that the release and consent is a condition of my son/ward being admitted to Camp.

I hereby certify that all the information given on this application is true and correct.