All Saints Cathedral School Summer  Camp  Registration  Form              

 Camper’s  Name:__________________________________________________________________________    Age_______________            Current  Grade    ________________      Attach  Copy  of  Immunization    Physical  Address:____________________________________________________________________________    Mailing  Address:_____________________________________________________________________________    Name  of  Parent/Guardian  1:________________________________________________________________    Contact  Numbers  (work):______________________    (cell):____________________________________    Home:___________________________________   E-­‐Mail  Address:_____________________________    Name  of  Parent/Guardian  2:______________________________________________________________    Contact  Numbers  (work):______________________    (cell):__________________________________    Home:___________________________________   E-­‐Mail  Address:_____________________________    Allergies:  ____________________________________________________________________________________      Payment:  Registration  $100.00  (non-­‐refundable)  Tuition  $500.00  :      (June  18th  –  July  20th,  2018)  8:30  A.M.  –  3:30  P.M.  $50.00  per  week  After  Care/Supervision  4:30  p.m.  –  5:30  p.m.  $1.00  per  minute  after  (Note:  there  is  an  added  $5.00  charge  for  credit  card  payments)  I   verify   that   my   child   has   medical   insurance   and   is   able   to   participate   in   the   All  Saints  Cathedral   School   Summer  Camp  Program.       I   further  understand  and  agree  that  there  will  be  no  refund  of  fees  after  my  child  has  begun  camp.    Parent/Guardian  Signature:_________________________________      Date:________________________    

Enclose  payment  with  registration  and  make  checks  payable  to  All  Saints  Cathedral  School