and qualify for the discount tuition posted online. camp ... · lohikan is an english speaking...
TRANSCRIPT
Credit Card/Debit Card Form
Credit card payments incur a 3% nonrefundable convenience fee. There is no charge for debit card payments or payments made by personal, business or bank checks. To make a credit card/debit card payment (Visa or Mastercard), please complete this form and mail it or email ([email protected]) it to us.
Our mailing address from mid September through June 7th is Camp Lohikan, P.O. Box 189, Gladstone, NJ 07934 USA.
Our mailing address from June 8th through mid September is Camp Lohikan, 343 Wallerville Road, Lake Como, PA 18437 USA.
Camper's Name ________________________________________________________ Amount to be charged (3% will be added to credit card payments) __________________________ Please apply payment to:
__ Initial Deposit __ 2nd Payment __ Balance Payment __ Other Please specify:_______________________________________________ If the payment is being made for extra program charges (i.e., paintball, golf trip, etc.), please complete the applicable registration form in your CampMInder account before completing this form.
CREDIT CARD INFORMATION
Card Holder's Name _____________________________________________________ Billing Address:__________________________________________________________ Card Holder's Telephone/Cell Number__________________
CARD TYPE: Visa___________ Mastercard ________ Card Number ___________________________________________________________ Expiration Date (mm/yy) ________________________ Security Code/CVV__________ Card Holder's Signature___________________________________________________ Today's Date ________________________________