How to Register for Summer Day Camps 1. Confirm that your BGCOP membership is current (Not a member? It’s easy and only $20/year! Membership application is available at any BGCOP location) 2. Update emergency contact information (below) 3. Complete Camp Registration (on back) and Parent Agreement (attached) 4. Complete Field Trip Permission Slip (attached) Emergency Contact Information Youth Name: ______________________ (First) ________________________ (Last) New Member Returning Member Site _________ Date of Birth:__________________ Age:_________ Gender: Other family members who attend the club: _______________________________________ Yes Youth lives with: Both Father Female Also attending summer camps? Yes No _______________________________________ Mother Male No Other:___________________ Primary Contact Information Name: ______________________________________ Relationship:___________________________ Address:___________________________________________ City:____________________________ Home Phone:__________________ Cell Phone:___________________ Alternate:________________ Emergency Contacts (other than primary contact) - please list two: Name: _______________________ Relationship:___________________ Phone: ________________ Name: _______________________ Relationship:___________________ Phone: ________________ Important medical information/allergies: _______________________________________________ __________________________________________________________________________________ Please mark each day camp your child plans to attend, under the appropriate age group. One registration form per child. Cubs Ages 6-8 Tigers Ages 8-10 Adventurers Ages 11-13 Theme Camps $85 per week June 14 Summer Break Let’s Just Play June 17-21 The Great Detective June 24-28 Wilderness Survival Adventure July 1-5 (Closed July 4) Big Top Adventures July 8-12 Pirates of the Caribbean July 15-19 My Masterpiece July 15-19 Tech Camp July 22-26 Ocean Adventures July 23-27 Under the Big Top July 29-August 2 It’s a Jungle Out There July 29– August 2 Jam Camp August 5-9 Wet and Wild August 12-16 Let’s Get Gooey August 19-23 End of the Summer Blast Sports Camps $95 per week June 17-21 Basketball (Location: MVS) June 24-28 Cheer (Location: MVS) July 8-12 Soccer (Location: MVS) July 22-26 Basketball (Location: MVS) August 5-9 Flag Football (Location: MVS) August 12-16 All-Sports Camp (Location: MVS) Total # of Weeks: Total Cost of Deposits: Total Balance: Deposit Balance Parent Agreement Refunds Refunds are not given for annual membership or Day Camp deposit fees. Refunds for program fees may be requested if cancellation is given within a reasonable time to allow the Boys & Girls Club to invite another member to take the place of the child(ren) for that specific program. Refunds will be allowed for any program in which we have to cancel. Please speak to the Day Camp Coordinator about applying for refunds. It may take up to two weeks to process a refund after approval. Billing Procedures All Day Camp fees are assessed in advance on a weekly basis. A non-refundable deposit of $25 is required in advance to reserve a child’s spot for each week of Day Camp. The remaining fees for the week are due on the first day of member’s attendance for the week(s) reserved. Payments may be made in person at the front desk, online at our website www.positiveplace4kids.org or mailed to our administration office. We accept cash, personal checks or credit cards (VISA, MasterCard, American Express). Please be aware that we do not keep petty cash and therefore, staff members cannot make change for parents or members for any reason. If paying in cash, payments must be in the exact amount. Because we are a non-profit organization, we are unable to extend credit for upcoming Day Camp sessions or fee based programs. Financial Assistance A multi-child discount is available for families signing up more than one child for the Day Camp program. This discount is $5 off the cost of each weekly camp. Financial assistance is available on a case-by-case basis. If you would like to request financial assistance for any/all weeks of day camp, please complete a Scholarship Application and submit income verification. I have read and understand the parent agreement: Printed name of parent/guardian:_____________________________________ Date:_____________ Signature of parent/guardian:__________________________________________________________ How did you hear about BGCOP Day Camps? Flyer from child’s school Flyer from another location:______________________ BGCOP website Other Website: _______________________________ Club Staff/ Club Member Other:_______________________________________ Thank you!