Family Camp Registration

Thank you for your interest in Family Camp: Return to the Village! Please complete the form below.

Today's Date
Date Format: MM slash DD slash YYYY
Family Members Attending
For each family member attending, enter a full name, date of birth, and phone number (if applicable) below.
Full Name
First Last
Birth Date
Date Format: MM slash DD slash YYYY
Phone
Full Name
First Last
Birth Date
Date Format: MM slash DD slash YYYY
Phone
Full Name
First Last
Birth Date
Date Format: MM slash DD slash YYYY
Phone
Full Name
First Last
Birth Date
Date Format: MM slash DD slash YYYY
Phone
Additional Information
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Adult Attendee Email
2nd Adult Attendee Email
Tuition Amount (choose one)
- FAMILY RATE: Each adult: $150 – $350 (sliding scale), each child: $100
- ADULTS REGISTERING AS INDIVIDUALS: $300 – $400 (sliding scale)
CAPTCHA

For more information contact us at earthartsithaca@gmail.com

Family Members Attending