DATE RECEIVED _____________ CHECK # ________ AMOUNT ____________ GROUP NAME ____________________________ CAMP REGISTRATION FORM In order for this application to be considered complete,a Registration Fee of $50.00 plus a Deposit of 3 weeks tuition and a completed health form MUST accompany this form. Any schedule changes made after June 4 are subject to an additional $25.00 fee and availability. There are no refunds or substitution of days due to absence for any reason. Child’s Name ______________________________________ Date of Birth _________ Age _____ Grade NOW attending ____ Male __ Female __ Phone# ______________ Address __________________________________________________________________ City ___________________________State _____ Zip __________________ Father’s Name ________________ Cell Phone# _______________ Work # _________________ Mother’s Name _________________ Cell Phone# _______________ Work # ____________ Other than parent, whom shall we contact in case of an emergency? ______________________ Phone # ____________________ ALLERGIES _____________________________________________________________ ALLERGIES _____________________________________________________________ MEDICATIONS _____________________________________________________________ AUTHORIZED PICK-UP ________________________________________________________ PLEASE FILL IN: TIME: 8:30-NOON ____ 12:30-4 ____ 8:30-4 ____ EXTENDED CARE AM ____ PM ____ EXACT HOURS ____________________ DAYS OF THE WEEK CAMPER WILL ATTEND – Minimum enrollment is two days per week. MONDAY ____ TUESDAY ____ WEDNESDAY ____ THURSDAY ____ FRIDAY ____ TOTAL DAYS ________ WEEKS CAMPER WILL BE ATTENDING – Minimum enrollment is three weeks. Please check off weeks attending.. 6/23 ____ 6/30* ____ 7/7 ____ 7/14 ____ 7/21 ____ 7/28 ____ 8/4 ____ 8/11 ____ 8/18 T-SHIRT SIZE – Please circle size Youth: 2-4 6-8 10-12 14-16 Adult: Small Medium Large X-Large TUITION INFORMATION: WEEKLY TUITION FEE ______________________ PAYMENTS: Payments are due the beginning of each week. Any late payments or returned checks are subject to a $25.00 fee. Tuition Fees and additional information are on the back of this page. If you have any questions, please do not hesitate to give us a call. Deposit: The three week deposit pays for the last three weeks your child attends camp PLEASE READ AND SIGN:
The New Jersey Department of Heal regulation under Chapter 375 P.L. 1973 NJ Youth Camp Safety Act Standards 8:25-3.2 Physical Examination (b) mandates the following: A Signed statement shall be required of each parent or guardian, in advance. I _____________________________________________ give permission to the physician selected by the camp to hospitalize; secure proper treatment for, and order injection, anesthesia or surgery for each camper. It is further understood that all reasonable efforts will be made to notify the parents (guardians) before any action is taken. THE UNIVERSAL HEALTH FORM MUST BE RETURNED IN ORDER FOR YOUR APPLICATION TO BE COMPLETE.
IMPORTANT CAMP INFORMATION – REGISTER EARLY! Last summer we turned away many campers. MEDICAL FORM: A medical form is required by State law and MUST accompany this registration form in order to be considered complete. No child is permitted to start camp without a completed health form. DISCOUNTS: A 5% discount on tuition will be granted to any camper who attends camp for six weeks and has tuition paid in full by May 15th. In order to receive a multiple child discount, campers in the same family must attend camp for at least six weeks. 10% second child – 15% third child. Discount is on tuition only and does not include registration fees or other camp fees. PAYMENTS: All payments are due the beginning of each week. Your last three weeks camp tuition is required with your application form and all other weeks must be paid for before the start of each week. You may pay a weekly fee or divide your balance into two equal payments with the last payment due before the last three weeks of camp. There will be a late fee charged to those paying late and it is our policy to charge $25 for any returned checks. Your child will not be permitted to continue attending camp if more than two weeks’ payments are delinquent. WITHDRAWALS and DEDUCTIONS: Written notice must be received regarding any withdrawals from camp. No deductions from tuition are made due to absences, weather or vacations. There are no refunds or substitution of days due to absence for any reason. You will be charged with exactly what you sign up for, therefore, be sure to include vacation time away from camp now – not after camp starts! CHANGES IN SCHEDULE: There will be a $25 change fee for changes made up until June 4th. These changes must be made in writing. After that time, no changes will be allowed and you are responsible for the full contract amount. REGISTRATION: The Shore Summer Camp is a nine-week camp. A camper may attend as little as three weeks or as many as nine weeks. You may pick and choose your days at camp as well as the weeks you will be attending on your application form. Remember that you will be charged and responsible for paying for the exact amount you register for. EXTENDED CARE: Extended care is available Monday through Friday as camp opens at 7 AM and closes at 6 PM. The extended care fee is $6.00 per extension. If you need extensions in the morning and afternoon the fee is $10.00 per day. This additional fee will be added to your camp tuition rate. If you need extended care on an occasional basis, you MUST pay for it the day you come early or stay late. There is a $1.00 per minute charge after 6 PM. TRIPS: Wednesday is designated as Shore Summer Camp Trip Day. All campers will receive permission slips that need to be returned with fee and parent/guardian signature in order to attend the trip. Trips are on a first come-first serve basis. No swim lessons on Wednesday due to the trips. No Tadpoles (2 ½ - 4) are permitted to attend the trips unless accompanied by their parents. HOT DOG DAY AND PIZZA DAY: Every Monday the campers will be able to purchase Hot Dogs, Soda and Chips with envelopes that will be provided to them. On Thursdays, we will have hot Pizza delivered to camp and campers may purchase a slice or two with soda by using the envelopes provided for this treat! SWIM LESSONS: The Shore Summer Camp provides group swim lessons every day but Wednesday. If you wish to have more individualized lessons they are available after 4 PM. Registration forms and fees for this program are available if you are interested. FEES: Camp fees include group swim lessons, snacks, arts and crafts materials, special daily events and supervised athletic activities. Fees do not include Wednesday Trips, Camp BBQ’s or Hot Dogs and Pizza. |