Sensational Kids Summer Camp Application 2018
Our Lady of Hope
Camper’s Name: ______Age: ______
Date of Birth: ______Sex: M___ F___ Home Phone: ( ) ______
Camper’s Address: ______Apt.: ______
City: ______State: ______Zip: ______
Camper’s School: ______Grade:______
Mother’s Full Name: ______
Mother’s Work #: ( ) ______Place of Employment: ______
Mother’s Mobile #: ( ) ______Email: ______
Father’s Full Name: ______
Father’s Work #: ( ) ______Place of Employment: ______
Father’s Mobile #: ( ) ______Email: ______
Emergency Contact Person: ______
Relationship to Camper: ______Phone #: ( ) ______
Please check each of the weeks you plan on having your child attend. (MINIMUM 2 WEEKS)
____ JULY2____ JULY 9____ JULY 16____ JULY 23
____ JULY 30____ AUG. 6____ AUG. 13____ AUG. 20
KindercampAges: 3 - 5 Only ____ 5 Full Days____ 5 Half Days
Junior Division____ Ages: 6 – 8 (or children who are 5 years old and have completed Kindergarten)
Senior Division____ Ages: 9 – 12Teen Camp ____ Ages: 13 - 14
Bus Service:
____ No ____ Yes ( ____ Round Trip $65.00 per week) ( ____ AM Only or ____ PM Only $50.00 per week)
If Yes, please indicate cross streets.
Cross Streets: ______
Having read all of the information in the camp application package, I agree to comply with all of the requirements and procedures of the program as stated in the camp policy. I also give permission to authorize emergency medical procedures if necessary. (PLEASE SEE ENROLLMENT AGREEMENT ON BACK OF THIS PAGE)
______
Parent or Guardian’s Signature Date
A non-refundable $75.00 registration fee and the required 2 week minimum $600.00 for a total of $675.00must be included with this application. Please make check payable to “Sensational Kids”.Please do not mail cash.
Office Use Only Mail to: Sensational Kids
Date Received: ______72-11 Austin Street
Fee: ______Suite 182
Comment: ______Forest Hills, NY 11375
ENROLLMENT AGREEMENT 2018
- A non-refundable $75.00 registration fee and the required 2 week minimum
must be included with all signed applications.
- The medical form must be completed and signed before a child is allowed to attend camp. The medical form does not have to accompany the application form but must
be on file prior to your child’s first day of camp.
- In the event that a parent cannot be contacted, the parent gives permission to the hospital or doctors to administer emergency medical treatment to the child.
4. The parent gives consent for their child to take supervised trips.
5. The parent gives consent for use of their child’s photo by the camp.
6. The camp reserves the right to terminate bus service in selected zip codes due to
limited attendance, or if the camp deems it necessary.
7. The camp reserves the right to terminate this contract if the fees are not paid in full,
for discipline or behavioral problems or if the camp deems it necessary.
8. There are no refunds for absences, withdrawals, changes or terminations.
9. Optional trips are based on a first-come, first-serve basis. Seats are limited for
each trip and are not guaranteed.
10. The camp will not be held responsible for lost, stolen or damaged articles including
toys, games, trading cards, personal items, etc.
11. Any changes made to your original application will incur a $20.00 fee for
each change.
12. Failure to maintain your monthly payment schedule will result in a $20.00 late fee
per month or a readjustment of the weekly rate.
13. A $20.00 fee will be charged for all returned checks. If this should occur, all
remaining fees must be paid with a money order.
14. The parent has read and agrees to the camp policy and fees, bus service policy, and
optional trip policy.
______
Parent or Guardian’s Signature Date