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Age 3 - 2nd Grade Registration
3rd - 5th Grade Registration
6th - 9th Grade Registration
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Camp Descriptions: Age 3 - 2nd Grade
Camp Descriptions: 3rd - 5th Grade
Camp Descriptions: 6th - 9th Grade
Recreation Camp
Drop-in Travel Camp: July 2 - 6
Transportation
Extended Care

Summer Camp >  Online Registration >  3rd - 5th Grade Registration > 

3rd - 5th Grade Registration

CAMPER INFORMATION:
Camper First Name
Camper Last Name
Gender

 Male  Female
Grade Entering 2012
T-shirt Size
Street
City
State
Zip
Phone Number
Email Address

CAMP REGISTRATION:

Please enter the number 1 in the box next to the camps this child would like to attend.
Week 1: June 18 - 22 (Choose one)
Full Day Camps (9 am - 4 pm): Includes themed camp in the morning and recreation camp in the afternoon (unless otherwise noted).
Adventure Bound (full-day: no recreation camp)  @ $395.00
Pokemon Tournament  @ $325.00
Morning Themed Camps (M-Th, 9 am - 12 noon; F, 9 am - 4 pm)
Pokemon Tournament  @ $175.00
Afternoon Recreation Camp (M-Th, 1 pm - 4 pm; F, 9 am - 4 pm)
Recreation Camp: 3rd - 5th  @ $175.00

Week 2: June 25 - 29 (Choose one)
Full Day Camps (9 am - 4 pm): Includes themed camp in the morning and recreation camp in the afternoon.
Helping Hands: Animal Rescue  @ $325.00
Woodworking  @ $325.00
Morning Themed Camps (M-Th, 9 am - 12 noon; F, 9 am - 4 pm)
Helping Hands: Animal Rescue  @ $175.00
Woodworking  @ $175.00
Afternoon Recreation Camp (M-Th, 1 pm - 4 pm; F, 9 am - 4 pm)
Recreation Camp: 3rd - 5th  @ $175.00

Week 3: July 9 - 13 (Choose one) 
Full Day Camps (9 am - 4 pm): Includes themed camp in the morning and recreation camp in the afternoon.
Harry Potter  @ $325.00
Helping Hands: Community Service  @ $325.00
Morning Themed Camps (M-Th, 9 am - 12 noon; F, 9 am - 4 pm)
Harry Potter  @ $175.00
Helping Hands: Community Service  @ $175.00
Afternoon Recreation Camp (M-Th, 1 pm - 4 pm; F, 9 am - 4 pm)
Recreation Camp: 3rd - 5th  @ $175.00

Week 4: July 18 - 22 (Choose one)
Full Day Camps (9 am - 4 pm): Includes themed camp in the morning and recreation camp in the afternoon (unless otherwise noted). 
Adventure Bound (full day: no recreation camp)  @ $395.00
Go Sketch!  @ $325.00
Morning Themed Camp (M-Th, 9 am - 12 noon; F, 9 am - 4 pm)
Go Sketch!  @ $175.00
Afternoon Recreation Camp (M-Th, 1 pm - 4 pm; F, 9 am - 4 pm)
Recreation Camp: 3rd - 5th  @ $175.00

Week 5: July 23 - 27 (Choose one)
Full Day Camps (9 am - 4 pm): Includes themed camp in the morning and recreation camp in the afternoon. 
Top Chef International  @ $325.00
Lego Robotics  @ $325.00
Morning Themed Camps (M-Th, 9 am - 12 noon; F, 9 am - 4 pm)
Top Chef International  @ $175.00
Lego Robotics  @ $175.00
Afternoon Recreation Camp (M-Th, 1 pm - 4 pm; F, 9 am - 4 pm)
Recreation Camp: 3rd - 5th  @ $175.00

Week 6: July 30 - August 3 (Choose one)
Full Day Camps (9 am - 4 pm): Includes themed camp in the morning and recreation camp in the afternoon. **Drama Camp is a two week session and runs weeks 6 & 7.
Tech Extreme  @ $325.00
Drama Camp (2 weeks)  @ $650.00
Morning Themed Camps (M-Th, 9 am - 12 noon; F, 9 am - 4 pm)
Tech Extreme  @ $175.00
Drama Camp (2 weeks)  @ $350.00
Afternoon Recreation Camp (M-Th, 1 pm - 4 pm; F, 9 am - 4 pm)
Recreation Camp: 3rd - 5th  @ $175.00

 
Week 7: August 6 - 10 (Choose one)
Full Day Camps (9 am - 4 pm): Includes themed camp in the morning and recreation camp in the afternoon.
If We Build It...  @ $325.00
Morning Themed Camps (M-Th, 9 am - 12 Noon; F, 9 am - 4 pm)
If We Build It...  @ $175.00
Afternoon Recreation Camps (M-Th, 1 - 4 pm; F, 9 am - 4 pm) 
Recreation Camp: 3rd - 5th  @ $175.00

BUS SERVICE:
AM Pickup Stop
PM Drop-off Stop

EXTENDED CARE:
Both AM and PM Care  @ $100.00
AM Care Only  @ $40.00
PM Care Only  @ $80.00
Form Total: $0.00

PARENT/GUARDIAN 1 INFORMATION:
Parent 1 First Name
Parent 1 Last Name
Relationship
Email Address
Cell Phone Number
Work Number

PARENT/GUARDIAN 2 INFORMATION:

Parent 2 First Name
Parent 2 Last Name
Relationship
Email Address
Cell Phone Number
Work Number

CREDIT CARD INFORMATION:
Name on Card*
Credit Card Type*
Credit Card Number*
Expiration Month*
Expiration Year*
CCV*

Registration & Enrollment Agreement
1. I hereby enroll my child in the Barnesville Summer Day Camp program for the sessions and services indicated on this registration form. I understand that my submission of this form does not itself guarantee acceptance; registrations are accepted on a first come first served space available basis.  
2. In the event that a program is full or not available I will be notified and monies will be refunded to me or credited for the use of another summer program.  
3. In submitting this form, I am agreeing to pay for the child named herein, the total tuition and fees as indicated on this form. 
4. In order to withdraw your child from a program, a request in writing is required no later than May 1, 2012. Payment will be refunded minus a 20% nonrefundable deposit.
5. MEDICAL CARE: I hereby give my consent to the Barnesville Summer Day Camp and any agent acting on its behalf to secure and provide any medical attention that might be necessary and urgent during a time when I cannot be contacted. I further agree to accept any medical expenses incurred on behalf of my child (registered herein), under the conditions described above.
6. FIELD TRIPS: I grant permission for my child to participate in off-campus field trips during the summer program using transportation arranged by the Barnesville Summer Day Camp.
7. BEHAVIOR: I understand that the Barnesville Summer Day Camp retains the right to exclude any child from participating in any activity, that in the Camp’s considered judgment, is not yet ready to participate safely or where the child’s participating at the time in question may interfere with the health and safety of others. The Barnesville Summer Day Camp reserves the right to dismiss, without refund, any camper whose behavior is unsafe or inappropriate.
8. PHOTOGRAPH/ PUBLICITY: I give the Barnesville Summer Day Camp permission to use artwork created by my child and photographs taken of my child during the summer in future Barnesville School and Summer Day camp promotional materials.
I agree to the conditions as stated above.
SIGNATURE:
DATE:
 
Please click "Next" to be taken to Page 2- Summer Camp Medical Form.  This page will refresh to take you to the next page.  Your credit card will not be charged until you click the "Submit" button on Page 2.

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