Registration – The Launch – Chestnut Hill Center

Student Name*

First Last

Student Email Address*

Student Cell Phone

Home Phone

Parent Name*

Parent Email Address*

Parent Phone Number*

Home Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Date Of Birth*

School*

Grade in Fall 2026*

Some participants of the Launch program have been involved with Sebago Leadership Camp. If you have been a camper at Sebago, please indicate below. Previous participation in Sebago is not required for this program.

Sebago Camper
No Previous Sebago Involvement

Electronic Devices Policy

Preferably, electronic devices (smartphones, iPads, and the like) will be left at home. The reason for leaving these types of devices at home is to foster a tone of camaraderie and friendship. Unfortunately, at times, electronic devices have the opposite effect—tending to isolate people and be an obstacle to conversation. If you do bring one of these devices, the staff will collect them upon arrival. There will be a couple of times during the camp that you will have access to them so you may respond to important messages or calls. (Coverage, however, may be quite limited.) Parents may reach participants at any time by calling JP Lechner at 202-733-0771.

Medical Information

List any pertinent medical information (allergies, medications, dietary requirements, etc.)

Insurance Company

Insurance Company Phone

Policy Number

Insurance Group Number (if applicable)

Application Authorization

Photo Release: I hereby authorize and consent to the use and reproduction by the Launch staff or an authorized agent or assignee of any and all photographs taken of my son for the purpose of promoting the Launch without any compensation to me. All film, together with any prints, shall constitute property of the Launch, solely and completely.

Liability Waiver: I hereby give permission for our son to participate in all activities conducted by the Launch. We agree to hold the directors and staff harmless from any liability to anyone on account of any injuries to our son. I understand that the Launch cannot be responsible for lost or broken items. I understand my son will comply with all cabin policies and procedures. I also understand, and will comply with, all cancellation policies and procedures.

Medical Release: I hereby delegate authority to the Directors of the Launch Program to arrange whatever medical treatment they deem necessary for him during his stay at the camp. By typing my name below, I certify that I am the parent or legal guardian of the applicant listed.

Electronic Signature of Parent or Legal Guardian*

Payment Policy, Fees, and Conditions of Application

Enrollment: To enroll your son in the program, we must receive your application and a $100 deposit. The remaining balance is due on or before June 1st. If cancellation occurs after June 1st, all payments will be forfeited unless space can be filled from our waiting list. If space is filled, all money, excluding the $100 deposit, will be refunded.

Payment should be made by check, payable to the Chestnut Hill Foundation, Inc.

Mail all checks to: The Launch Program 481 Hammond Street Chestnut Hill, MA 02467

Amount Paying Now

Amount to Pay Now*

Launch Registration (Full)
Launch Registration (Half)
Launch Registration Deposit

Please select the amount you can pay now.

Payment Method*

Pay Online (credit card, PayPal)
Pay By Check

Scholarship Request

Total Due Today

$0.00

The Launch: Program Registration

Electronic Devices Policy

Medical Information

Application Authorization

Payment Policy, Fees, and Conditions of Application