T H E C H R I S T I A N C O M M U N I T Y
I N T H E G R E A T E R W A S H I N G T O N - B A L T I M O R E A R E A
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 _________________________________________