Online Application Online Application "*" indicates required fields Contact InformationCamper Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Parents' Primary Phone*Parents' Secondary PhoneParents' Text #*Parents' Email* Campers' Email Personal InformationName of Parent (s)*Camper Date of Birth*Grade in the Fall of 2026*Sex* Male Female Please describe any special needs, medications, etc. you haveCamp InformationDate of Camp*Choose DateJuly 11 - 24, 2026Departure/Return Location*Choose LocationJeffersonton, VAWarrenton, VAHaymarket, VALeesburg, VAFrederick, MDHarrisburg, PAWilliamsport, PAPainted Post / Corning, NYMount Morris, NYBuffalo, NYNiagara, OntarioBurlington/Hamilton, OntarioOakville, OntarioKing City/Maple (Toronto Area) OntarioBarrie, OntarioPort Severn, OntarioParry Sound, OntarioSudbury, OntarioAirport - Buffalo, NYAirport - Toronto, OntarioAirport - Sudbury, OntarioUnsure at this timeHow did you originally find out about TASC?*Select SourceFriendInternet SearchInternet AdvertisementCamp ConsultantCamp FairNewspaperMagazineOtherInsurance InformationHealth Insurance CompanyPolicy NumberCheck if you do not have health insurance I do not have health insurance Parent/Guardian AuthorizationBy checking below, I hereby give my permission for my son to participate in this camp. 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 participate. Any allergies, medications, or special needs have been noted on this form. In case of emergency, the senior staff member has my permission to secure any emergency medical care deemed necessary by a licensed physician. I agree to the Cancellation Policy on the TASC website.Must be checked by parent or legal guardian* I GIVE my authorization I DO NOT GIVE my authorization Camper AgreementBy 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 transportation back home.Must be checked by camper* I read and I ACCEPT the Camper Agreement I DO NOT ACCEPT the Camper Agreement Payment MethodSelect payment method* Mailing FULL PAYMENT - check, money order, cashier's check Mailing DEPOSIT -check, money order, cashier's check Contact TASC to pay by credit card