CAMP ASHMERE SUMMER REGISTRATION FORM 2010

Camper Information
Camper's Name:		Male Female
Address:
City: State: Zip Code:
Birthdate: Age: Entering Grade:
Emergency Contact Information
Parent/Guardian #1: Phone Place of Employment: Work Phone:
Parent/Guardian #2: Phone: Place of Employment: Work Phone:
If we are not able to reach the person(s) listed above, whom should we contact in case of emergency? Name: Phone: Relationship to Camper:
Additional Contact Information
Who is registering this camper for camp? Name: Relationship to camper:
Address:
City: State: Zip Code:
eMail address:
Camper's Home Church: Phone: Pastor's Name:
Photographs, video, and/or other images of my child MAY be used for the promotion of Camp Ashmere. Photographs, video, and/or other images of my child MAY NOT be used for the promotion of Camp Ashmere.
Camp Session Grade Level Dates Price DAY CAMPS Day Camp - Session I 1 - 4 July 12 - 16 $ 150.00 Day Camp - Session II 1 - 4 August 16 - 20 $ 150.00 OVERNIGHT CAMPS Explorations I 4 - 6 August 1 - 7 $ 325.00 Explorations II 4 - 6 August 8 - 14 $ 325.00 Splash Camp 5 - 8 July 11 - 17 $ 395.00 Senior Tradtitions 7 - 10 July 18 - 24 $ 385.00 Senior Adventure I 7 - 12 July 25 - 31 $ 395.00 Senior Adventure II 7 - 12 August 1 - 7 $ 395.00 Leadership Training Camp I 9 - 11 July 11 - 17 $ 100.00 Leadership Training Camp II 9 - 11 August 15 - 21 $ 100.00
If registering for two consecutive overnight camps, will camper be staying at camp between sessions? Yes (add $40 stayover fee)
All Day Camps must be paid in full at the time of registration. All Overnight Camps require a non-refundable* deposit of $50 per session. *Exception: Admission to Leadership Training Camp is by application only. Deposits for LTC applicants who are not accepted will be refunded.