Please circle the camp sessions you would like to attend, the days of
Child’s Name ____________________________________ Birth Date _______________________________________ Parent’s Name ___________________________________ Cell # ______________________________________ Address_________________________________________ Home Phone #____________________________________ Father’s Employment ______________________________ Work Phone # _____________________________________ Mother’s Employment _____________________________ Work Phone # _____________________________________ Emergency Contact ________________________________ Emergency Phone # ________________________________ Child’s Doctor _____________________________________ Doctor’s Phone # __________________________________ Allergies and/or restrictions __________________________ E-Mail ______________________________________________ Please circle the camp sessions you would like to attend, the days of the week and the hours. We will return this form to you confirming your camps. CAMP DATES Days of Week— circle days attending (Pre Camp) June 8-12 6/8 6/9 6/10 6/11 6/12 Morning Part Full Camp 1 (GIANTS of Fact & Fiction) June 15 - 26 6/15 6/16 6/17 6/18 6/19 Morning Part Full 6/22 6/23 6/24 6/25 6/26 Morning Part Full Yes, my child will enroll for the full Adventure Camp(5 days) 6/29 6/30 7/1 7/2 7/3 Camp 2 My child will enroll for 3 days of Adventure (Inspired by Disney) 7/6 7/7 7/8 7/9 7/10 June 29 - July 10 My child will enroll for 2 days of Adventure Hours— please circle Morning 9:00 am-11:30 am / Part Day 9:00 am-3:30 pm/ Full day 6:30 am-6:00 pm Amount pd. Morning-$30 day Part day-$60 day or $230 week Full day-$66 day or $265 week FOR OFFICE USE ONLY: $ 398 per 2 wk camp. $10 per field or swimming pool trip. Morning Part Full $ 270 per 2 wk camp. $10 per field or swimming pool trip. Morning Part Full $ 180 per 2 wk camp. $10 per field or swimming pool trip. Extended Camp: Before Care 7/13 7/14 $7/15 10 per7/16 day 7/17 Extended After Care $10 per day Morning Camp: Part Full Camp 3 (Young Inventors) All Day Care( 7 am— 6 pm) : $225 week7/22 or $567/23 per day. 7/20 per 7/21 7/24 Morning Part Full July 13 - 24 Do You Need Care for the Week of June 7, 2010? No or Yes What days ?( pls circle): Mon. Tues. Wed. Thurs. Fri. 7/27 7/28 7/29 7/30an Authorization 7/31 Morning PartMedicalFull Camp 4 GAP students, pay a $75 enrollment For new fee and complete for Emergency Care and My Child’s Biography and (Crazy Creations) returned by the first day of camp. If you need to update existing forms, please come into the office for a new form. All forms must be on file byJuly the first day of camp. 8/3 8/4 8/5 8/6 8/7 Morning Part Full 27-August 7 (End of Summer) August 10-14 8/10 8/11 8/12 8/13 8/14 Morning Part Full *For new GAP campers, an Authorization Form & My Child’s Bio must be completed before the 1st day of camp. Registration Terms: First week of tuition due upfront to hold spot. Unused days are non-refundable & non-transferable for any reason. Two-week cancellation fee All children attending water field trips must purchase a rash guard from Grand Ave No REFUNDS due to cancellation, including field trips. 20% discount for siblings To ensure a safe and fun camp experience, I agree to honor all camp policies and pay all camp fees. Parent Signature_____________________________________________________________________ adventurecampenroll
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