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Tilden Summer Camp Application

July 2 – 8, 2017

JUNE 5 REGISTRATION DEADLINE

Boy's Name*
Entering Grade*
Parent email for communication*
Home Phone*
-
Father's Name:*
Mother's Name:*

The following hobby classes are offered this summer.

Please number your first two preferences,

with “1” being your first choice.

1st Choice*
I will pay by:*

The fee for the camp is $425
($640 for two campers who are brothers)

To pay by check, mail check payable to:

Tilden Study Center
655 Levering Avenue,
Los Angeles, CA 90024

To pay by credit/debit card (in full or in monthly installments):

Make a Payment

Date of Birth *
 / 
 / 
School now attending*
Other parent email for communication
Parent / Emergency Cell Phone*
-
Home Address*
2nd Choice*

Please indicate any allergies or other health factors
that should be known by the staff:

Health Factors

How did you hear about Tilden Summer Camp?
Additional Information (optional):
Application Verification