TRINITY SUMMER FUN CAMP 110 SW 11th STREET Downtown Fort Lauderdale 954-600-4953 June 9 - August 15, 2014 SUMMER CAMP PROGRAM 10 Weeks June 9 – August 15 Ages 5 (K) through 12 (6th grade) REGISTRATION FEE $75.00 includes t-shirt and insurance Extra Shirts 10.00 each WEEKLY TUITION $160.00 DAILY TUITION $40.00 Includes all field trips and BBQ Friday Must wear shirts every day Lunch available for purchase @ $20.00 per week in advance. Pizza Wednesday is $5.00 CAMP HOURS 7:30 am-4:00 pm Aftercare available until 6pm $5.00 per day SEE CAMP CALENDAR FOR DAILY ACTIVITES REGISTRATION FORM Child’s Name: ___________________________________ Date of Birth: __________________________________ Home Phone: ___________________________________ Grade Completed: _______________________________ Shirt size: _____________________________________ School Attended: _______________________________ Parent’s Name: _________________________________ Parent’s Address:________________________________ City, State, Zip: ________________________________ Place of Employment:____________________________ Work Phone:____________________________________ Cell Phone: _____________________________________ Insurance: ____________________________________ Policy number: __________________________________ Name of Doctor: ________________________________ Phone for Doctor:____________________________ Emergency Contact: ______________________________ Phone: ________________________________________ Persons allowed to pick up my child: __________________ Allergies or Medications: __________________________ Photo Release I Hereby grant authorization to Trinity Summer Fun Camp and Trinity Lutheran School to use photographs of myself and/or my child for publicity purposes. ____________________ _____________________ Signature date REGISTRATION FORM My child will attend the following weeks: (Circle all that apply) June 9 June 16 June 23 June 30 July 7 July 14 July 21 July 28 August 4 August 11 I understand that the calendar is scheduled and reservations are made based on registrations. I agree to pay $160.00 per week for Summer Camp. This is paid according to the weeks registered for, not for the days in attendance. ___________________ ____________________ Signature date Summer Camp Permission I, the undersigned parent/guardian of ______________ hereby give consent for my child to participate in all of the field trip activities associated with Trinity Summer Fun Camp program at Trinity Lutheran Academy from June 9 – August 14, 2014. I understand that I will know in advance, what the activities are and when the children will be leaving the campus and the approximate time of return. With this signed agreement, I absolve the Camp Director: Trinity Lutheran Academy: and all members of its governing boards; and any parents who chaperone, of any responsibility for the safety; welfare; health and well-being of my child beyond such matters as may be called reasonable care for children in custody of a counselor and subject to the counselor’s clear instruction, and assumes personally and exclusively all responsibility and liability for accident; injury; etc.’ which may occur to the above named child during any of the summer camp activities. I hereby give Trinity Lutheran Academy, Trinity Summer Fun, expressly the Camp Director, my express permission to use his/her judgment in case of extreme emergency when no parent or other member of the immediate family of my child can be located. He/she may give the hospital permission to do whatever is necessary with regard to emergency medical or surgical treatment. ____________________ _____________________ Signature date
Posted on: Thu, 20 Mar 2014 16:13:53 +0000
Trending Topics
Recently Viewed Topics
© 2015