2012 PRE-SCHOOL SUMMER CAMPREGISTRATION FORM
Camp Program Registering For _____________________ Session ________________ ____________________________________ __________________________Child’s Name Date of Birth _____________________________________________________________________Address, Apt. #, Zip __________________________ __________________ ___________________Parent/Guardian Name Home Phone Work Phone _____________________________________ __________________Email Address Cell Phone
A deposit of half camp fee is due at registration, plus $50 registration fee, $60 liability &$20 insurance. (Registration fee can be converted to family membership).In registering for camp, I accept all terms of enrollment and give permission for my child toparticipate in all activities. I understand the center assumes no responsibility for personalproperty. A medical form must be completed and submitted to us by June 1, 2012.
______________________________________ __________________________Parent/Guardian Signature Date ______________________________________________________________________Camp Fee________________ Registration Fee _______________Accident_________________ Liability ______________________Deposit __________________ Amount Due __________________Payment Type_____________ Receipt # _____________________
Session I: July 2-July 27Session II: July 30-August 17Full Session: July 2-August 17(closed July 4)
NEW THIS YEAR!
If your child is entering Kindergarten in September you caneither go to our Mosholu Day Camp for a more developed outdoor programi.e. learn to swim, or remain with us for the summer
FOR INFORMATION, PLEASE CALL FAITH SHEIN AT 718-882-0941
PRE–SCHOOL SUMMER CAMP 2012
Monday, July 2 to Friday, August 17For 2 to 5 year olds