Registration Checklist for The Christian Community Summer Camp 2016

 

    Fill out Registration Form --One Registration Form per child.

      Send deposit or full amount along with Registration Form to:

                        Rev. Carol Kelly

                        4221 Metzerott Road

                        College Park, MD 20740

 

  Fill out the Health Form. Please send to:

                        Dr. Margarethe Hertle

                        1320 Route 217

                        Ghent, NY 12075

 

   Please refer to packing list on our website.

   Please check your child for lice before sending him/her to camp.

 

“In the woods we return to reason and faith.” - Ralph Waldo Emerson

 

 

Registration form

 

Child’s Name_________________________________________________ Birth Date_____/______/__________ 

  

____Girl ____Boy

 

Address_____________________________________________________________________________________

 

Home Phone (______)_____-__________ Parent’s Cell (______)_____-__________

 

Parent’s Email__________________________________Emergency Contact____________________________

 

*Swimmer ____yes _____no   *Vegetarian  ____yes  ____no   *Food Allergy_______________________ 

 

*Grade in September________School____________________________________________________________

 

      ____I am enclosing payment in full $900 – if received before May 1st

      ____I am enclosing payment in full $975 – payable by June 1st           

      ____I am enclosing a non-refundable deposit of $175 and will pay the $800 balance by June 1st

      ____I am enclosing a donation of $____________ for the Financial Assistance Fund

      ____I am enclosing $100 for Bus Transportation FROM Chestnut Ridge ONLY

      ____I am enclosing $100 for Bus Transportation TO Chestnut Ridge ONLY

      ____I am enclosing $200 for Bus Transportation ROUND TRIP

 

 

Parent’s/Guardian’s Name ____________________________________________ 

 

Parent’s/Guardian’s Signature _________________________________________