Cathedral of Faith Christian School Camp Cathedral 2015 – Summer Program June 15th – August 21st Camper’s Last Name___________________ First Name____________________ Street Address________________________ City, State & Zip________________ Telephone Number_____________________ Gender: M or F; Race:___Age__Grade__ Father/Guardian_______________________ Social Security #:_______________ Employer_____________________________ Work #:_______________________ Work Address__________________________ Cell Phone #:___________________ Mother/Guardian_______________________ Employer_____________________________ Work Address_________________________ Social Security #:________________ Work #:________________________ Cell Phone #:____________________ If parents are divorced, with whom does the child reside?__________________________ *Must complete application and registration fee, $35.00, for child to attend camp. Camp Hours: 6:00 a.m. thru 6:00 p.m. Please check the dates the camper will attend: There will be a $20.00 fee for no-shows if you do not notify the office at least one week in advance of change. IF A CHILD ATTENDS ANY PART OF A WEEK, THE FULL CHARGE APPLIES FOR THE ENTIRE WEEK. Camp fees are due each Monday morning upon sign-in for that week. Week June 15 - 19 June 22 - 26 June 29 - 03 July 06 - 10 July 13 - 17 Yes No Week July 20 - 24 July 27 - 31 August 3 - 7 August 10 - 14 August 17- 21 Yes No Camp will be closed July 3, 2015 in observance of Independence Day. Campers will be supplied breakfast, lunch, snacks and drinks daily. **NOTE: Breakfast will be served from 8:30 a.m. until 9:00 a.m. ONLY!! Campers will need to wear sneakers daily, no open toe sandals. If the camper is not wearing the proper footwear, he/she will not be permitted to participate in outdoor activities for safety reasons. Campers will also need a life vest and shower shoes for swimming at the YMCA. No bikinis, water wings or inflatable vest will be allowed. Additional required forms: Medical History, Health Care Authorization and Authorized Pick-Up List Fees: One Child $135.00 weekly Two Children $257.00 weekly Three Children $365.00 weekly Summer Camp T-shirt (to be worn on all field trips): $10.00 – You may want to purchase two. Late Fee Late Pick-Up Fee $10.00 (payments not received on Monday). A charge of $1.00 per minute, per child who is picked up after 6:00 p.m. is to be paid by the parent or person(s) picking up the child upon arrival. This money will not be applied to your account; it must be paid on the day of the late arrival. NOTE: If tuition for this program is delinquent by two (2) weeks, your child will be suspended from this program. There will be no exceptions. Parent/Guardian understands that the school’s principal reserves the right to request withdrawal of a child that is unable to adjust to the program after a reasonable period of time. Yes, I have read and acknowledge the attendance and payment policy. Parent/Guardian Signature________________________________ Date__________________ Parent/Guardian Signature________________________________ Date__________________