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2. school

MERRICK COMMUNITY NURSERY SCHOOL
SUMMER CAMP REGISTRATION 2015
EXPIRES 8/31/2015
I hereby apply for admission to Merrick Community Nursery School Summer Camp, 2015.
Child’s Name ____________________________________________
Date of Birth ________/_______/_______
Sex ________
Age _______
Mother’s Name ______________________________________
Father’s Name ______________________________________
Address
___________________________________
Town
___________________________________
ZIP Code _____________
Telephone # ________________________ Alternate Tele # ________________________
Email _______________________________________________
Are you a current member of MCNS?
Yes
No
Is your child toilet trained? _______________________________
Previous camp or school separation experience ?
How did you hear about our camp?
______________________________________
_______________________________________
Please circle desired session
Fee Schedule
FULL
5 days
M-F
3 days
M-W-F
2 days
T-TH
8 weeks
2000.00
6 weeks
1650.00
4 weeks
1200.00
1440.00
1170.00
840.00
1120.00
900.00
640.00
HALF
5 days
M-F
3 days
M-W-F
2 days
T-TH
8 weeks
1600.00
6 weeks
1350.00
4 weeks
1000.00
1080.00
900.00
660.00
800.00
660.00
480.00
Camp dates - Please indicate which session
8 weeks: June 22 – August 14
6 weeks: June 22 – July 31
4 weeks: June 22 - July 17 OR
FULL 10am –3pm
HALF 9:30am-12:30pm
July 20 - August 14
(OVER)
I understand that:
A deposit of $200.00 is required with the application. The deposit is refundable until April 1, 2015 if:
a) My child cannot be accepted into the program.
b) My child is unable to attend the program, and I inform the school in writing before
April 1, 2015.*
*A $100 processing fee will be retained if your deposit is returned for this situation.
1. No reduction, refund of fees, or substitution of days will be allowed for absence. There will be
no exceptions to this policy.
2. Enrollment changes made after April 1, 2015, may only be made with the consent of the school.
3. CAMP IS CLOSED ON JULY 4TH AND THERE IS NO MAKE-UP DAY.
4. All balances are due by June 1, 2015.
5. My child must be toilet trained to use the pool. Ask about our sprinkler program for non-toilet
trained children.
6. If I wish to extend my child’s stay in camp, there will be an additional per diem cost.
7. Tuition is non-refundable after April 1, 2015.
8. One parent from each family MUST attend the parent orientation.
Date_______________________ Parent’s Signature __________________________________
Please use the attached envelope to mail in your application and deposit
Merrick Community Day Camp has a required permit with Nassau County Department of Health, and is inspected twice
yearly. Inspection reports are on file at 200 County Seat Drive, Mineola, NY 11501.
MCNS admits students of any race, color, and national or ethnic origin.
FOUNDED IN 1955* REGISTERED WITH THE STATE OF NEW YORK
For office use only
Date Rec’d ______ Check # _______
Rev 1/15
$200 Deposit ________ Tuition ________Balance Due_______