Please fill in all information below and be sure to circle one program choice for each child.

Child #1: Name ________________________Age ___ Grade Level in the Fall ___

Child #2: Name ________________________Age ___ Grade Level in the Fall ___

Child #3: Name ________________________Age ___ Grade Level in the Fall ___

Please indicate the number of children that will attend:

___July 7-11     ___July 14-18     ___July 21-25

___July 28-Aug 1     ___Aug 4-8     ___Aug 11-15

Please indicate one session choice by writing child's name in the blank:

Summer Camp 2008 Fee Payment Contract

Signature indicates responsibility to pay camp fee as indicated  Signing also indicates understanding that all selected weeks will be paid for regardless of attendance, as staff decisions will be made based on number of students registered, not numbers in actual attendance.

Student Name/Names ______________________________________________

Person Responsible for camp fee payments:

Name ______________________________ SS# _________________________

Address _______________________________ Phone # ___________________

_________________________________
Signature

________Pay in Full                ________Pay Weekly