Real Life Day Camp Registration Form

Real Life Jr. Day Camp Registration Form 2010

Please complete this form to register your 4-5 year old for Jr. Day Camp

Camper Information

Last Name:	First Name:
Address:	City: State: Zip:
DOB: / / Sex:	Home Phone: () -

Mother Information

First Name:	Last Name:	Cell: () -
Place of Employment:		Work: () -

Father Information

First Name:	Last Name:	Cell: () -
Place of Employment:		Work: () -

Additional Information

Any problem areas in the camper’s life of which the directors should be aware? (If yes, please explain):

How did you first learn about our camp?

List anyone other than a parent to whom your child may be released:

Name: Phone: () -
Name: Phone: () -
Name: Phone: () -

To register your child, please check the box of each day they will be attending camp. Days that he or she will not be attending, please leave blank. Then click the "Calculate my Deposit" button. Your total deposit, including registration fee, for this child will appear in the box below.

There is a Deposit Fee required of $5.00 per day. This deposit will be deducted from the total amount due for that week. To calculate your required deposit, simply multiply the number of days your child will be attending by $5.00. The button below the calendar will calculate your deposit for you.

The Registration Fee (separate from the deposit) is $25.00 per child per summer. To register your child for Summer Camp the registration and deposit fees must be paid in full and mailed with this registration form. Make checks payable to Real Life Day Camp and Farm.

**Registration Fees Are NON-Refundable**

**Deposit Fees Are NON Refundable and NON Transferable After May 16, 2010**

MINIMUM ENROLLMENT IS 2 DAYS PER WEEK

Week	Monday	Tuesday	Wednesday	Thursday	Friday
6/21 - 6/25
6/28 - 7/2
7/5 - 7/9	CLOSED
7/12 - 7/16
7/19 - 7/23
7/26 - 7/30
8/2 - 8/6
8/9 - 8/13
8/16 - 8/20
8/23 - 8/27
8/30 - 9/3					CLOSED