Real Life Day Camp Registration Form

Real Life Day Camp Registration Form 2012

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.

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 electronic calendar below can calculate your deposit for you. After checking the boxes, click the "Calculate my Deposit!" button below the calendar).

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 20, 2012**

MINIMUM ENROLLMENT IS 2 DAYS PER WEEK

Week	Monday	Tuesday	Wednesday	Thursday	Friday
6/18 - 6/20
6/25 - 6/29
7/2 - 7/6			CLOSED
7/9 - 7/13
7/16 - 7/20
7/23 - 7/27
7/30 - 8/3
8/6 - 8/10
8/13 - 8/17
8/20 - 8/24