Pine Island Camp Application

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Thank you for your interest in joining our 2021 season! Please fill out the form below and we will be in touch with you shortly to schedule a time to meet with director Sumner Ford.

We currently have a wait list for our traditional camp program and limited spots available in our Expedition Camp program. If your son is interested in our traditional camp program, please fill out this form to add him to the wait list. If your son is interested in our expedition camp program, please fill out this form and we will schedule a meeting with Sumner shortly after receiving your application.

Our 2021 Camp Dates are June 25 - August 8. Tuition for the 2021 season is $9200 if enrolled in our traditional camp program and $9700 if enrolled in Expedition Camp. As was true in 2020, if we cancel camp due to COVID-19 in 2021, your deposit and tuition will be fully refundable.

Camper's Full Name *

Name he goes by (if different)

Grade to be Completed this spring *

Age on June 25, 2021 *

Date of Birth *

Parent #1 Name *

Parent #1 Cell Phone *

Parent #1 Home Phone

Parent #1 Email *

Parent #1 Street Address *

Parent #1 City, State Zip *

Parent #2 Name

Parent #2 Cell Phone

Parent #2 Home Phone (if different than Parent #1)

Parent #2 Email

Parent #2 Street Address (if different than Parent #1)

Parent #2 City, State Zip (if different than Parent #1)

Other Contact Person, Relationship, and Phone number

How would you like to meet with Camp Director Sumner Ford? *

Sumner meets with all new camp families.

We would like to schedule a Zoom meeting.

We would like to schedule a phone call.

We have already met with Sumner.

Other:

Required

Would your son like to be considered for our Expedition Camp program? *

In addition to our traditional camp program for boys ages 9 - 15, we also offer Expedition Camp. Our Expedition Camp program is designed for 15- and 16-year-olds who are interested in leadership training. It's an intensive program that teaches boys trip planning and takes them on extended camping trips. Please note that the tuition for Expedition Camp is $9700.

Yes, my son is 15 or 16 years old and he is interested in the Expedition Camp program.

My son is 15 years old is he is undecided about which program is best for him. (We will contact you to talk about this.)

No, my son is interested in the traditional camp program.

Other:

Required

How did you learn about Pine Island Camp? *

My son is a returning camper

I am a former camper or staff member

I learned about camp from a camp parent

I learned about camp from a PIC alum

Magazine article or book

Facebook or Instagram

Google Search

Other:

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