Click here to download the Registration & Policy Forms in Adobe (.pdf) format to print out and email, fax or mail in.

Please fill out all fields that apply.  Required fields are in blue.

Camper information:

First name
Last name
Date of birth
School
Grade in the Fall
Sex	Male Female

Please provide the following contact information:

Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Home Phone
Work Phone
FAX
E-mail

General info:

Choose Departure/Return Location:
Choose Location Jeffersonton, VA Warrenton, VA Leesburg, VA Frederick, MD Harrisburg, PA Williamsport, PA Corning, NY Mount Morris, NY Buffalo, NY Niagara, Ontario Burlington/Hamilton, Ontario Oakville, Ontario Toronto, Ontario Barrie, Ontario Airport - Buffalo,NY Airport - Toronto,Ont. Airport - Sudbury, Ont.

Please describe any special needs, medications, etc. you have:

How did you originally find out about TASC? Select Source Friend Internet Search Internet Advertisement Trade Show Newspaper TV Commercial Magazine Radio other


Insurance info:

Check if you don't have health insurance


Select Payment Method: Payment may be made by check, money order, cashier's check, Visa, MasterCard, Discover or American Express. Deposits are non-refundable. If cancelled less than 30 days before camp begins, applicant is liable for 50% of cost of trip. No refunds are made if the camper returns home after the camp begins.

Mailing FULL PAYMENT (check, money order, cashier's check)
Mailing DEPOSIT (check, money order, cashier's check)
Charging FULL PAYMENT to my credit card
Charging DEPOSIT, PAYMENT OR BALANCE to my credit card

To pay with a credit card or using PayPal:

After you click "Send Application" below, you will see a link to the payment page where you can make a secure on-line payment.

Parent or Guardian Authorization:

By checking below, I hereby give my permission for my son/daughter to participate in this trip. I understand that TASC cannot be responsible for theft or damage to personal property, or injury. I certify that my child is normally healthy and is physically able to particapate. Any allergies, medications, or special needs have been noted on this form. In case of emergency, the senior staff member has my permission to secrure any emergency medical care deemed neccessary by a licensed physician.

Camper Agreement:

By checking below, I agree to abide by the policies of TASC and to cooperate with the leadership of the trip for the benefit of all. TASC sees no place for alcohol or drugs of any kind on any of its activities. If a participant does not follow this policy, TASC reserves the right to demand that the parents immediately provide for his/her transportation back home.