Sign Up Form

Homesteader Name:
Parent Name:
Address:
Town:State:Zip:
Phone Number:Cell:
Email Address:
Birthdate:
School and Grade as of Sept. :
  I enclose a deposit of $150 (Partially refundable by 6/7)
  I enclose the full enrollment fee and deposit of $650
  I'm interested in a campership for my child and want to enroll my child now. Please call me.
  We consent to let Village use photographs of my/our child on marketing material.
How did you hear about Village?
Parant/Guardian Signature:



Please mail your completed form to :

The Game of Village
c/o Tom Buttrick
9 Log Cabin Road
Nelson, NH 03457

 


The Game of Village Inc. is a non-profit 501(c)3 organization founded in 1983.