2017 Camp Wyomoco Registration Form enroll online:
2017 Camp Wyomoco Registration Form Mail completed application and deposit to Camp Wyomoco business office, 36 CENTER St. SUITE B, Warsaw, NY 14569
CAMPER INFORMATION:
choose a WEEK:
name: _________________________________________________________ birthdate: ________________________
____ male ____ female
select week(s) below SUPERHERO WEEK
July 2-July 7
street Address: ________________________________________________
July 9-July 14
city/st/zip: _____________________________________________________
July 16-July 21
4-H Member: Y N
July 23-July 28
How did you hear about us? _________________________________ IF Prior Camper, No. of Years? ________________________________ if referred, by whom?_________________________________________ Parent/guardian 1: ___________________________________________ phone: _______________________ alt. phone: ____________________ email:__________________________________________________________ Parent/guardian 2: ___________________________________________ phone: _______________________ alt. phone: ____________________ email: _________________________________________________________
*note: All correspondance will be by email.
Pickup authorization _________________________________________
July 30-August 4 LEADERSHIP WEEK August 6-11
Order a t-shirt: (optional, pre-order only-$10)
YOUTH 10/12 youth 14/16 adult small adult medium adult large adult x lrg Adult xx lrg
Cabin-mate request*: (must be within 2 years of age.) *Although we try to accomodate cabinmate requests, they are are NOT guaranteed.
enroll online:
www.CampWyomoco.com
activities: (AQ) Aquatics (AR) Archery (BT) BOATING (EC) Ecology & Nature (OL) Outdoor Skills (PA) Performing Arts (sp) Sports (VA) Visual Arts counselor in training (cit1) c.I.T. - 1 (AGE 14 by 7/1/17) (cit2) c.I.T. - 2 (AGE 15 by 7/1/17) (cit3) c.I.T. - 3 (AGE 16 by 7/1/17) horse programs: (hs) horse activity (wks 2-5)-$125 (HF) horse focus (wk 4 and 5)-$175 horse camp (wk 1 only) (hc) bring a horse - $150 (rh) rent a horse - $200 use the codes above to choose your top choices for activities.
1 ________ 2 ________ 3 ________ 4 ________
2017 camp registration fees 2017 Weekly Fees: $345/week Pre-Order T-Shirt (optional) $10 Horse Program Fees (from above) Total 2017 CAMP FEES: Wyoming Cty 4-H member - -$50/week Other Cty 4-H member -$25/week Day Camp Discount-$25/week Early Bird- (before 4/15) -$25/week Multiple Week Discount-$50/addt’l week 4-H Cookie Campership Credits Total 2017 DISCOUNTS:
TOTAL 2017 fees DUE: refund policy & Parent authorization Before the start of camp:
PAYMENTS required with registration:
Any unpaid balance must be received prior to camp session. Non-Refundable Deposit Horse Fees (payment must be included with registration) Camp T-Shirt (payment must be included with registration) Additional Payment (optional)
$100
Amount PAID WITH REGISTRATION: PAYMENT ENCLOSED bill credit card:
Name on card Card Number Exp. Date: Signature
CSC Code: Date
Authorized Amount
e, minus the deposit, will be refunded. A letter from a balance, minus the deposit, will be refunded. Refunds for the balance of the camp fee, less the deposit, are made ONLY for cancellations received in writing at least three weeks prior to the opening day of the camp session. During camp: of the camp period will be made on a prorated basis, minus deposit, oblem, no refund will be granted. Under no circumstances will the deposit be refunded or transferred. Parent or Legal Guardian: I have read this application, including my child’s choice of activities. By signing below, I approve of my child’s activity choices, including any additional fees that may be associated
with this registration is non-refundable and non-transferable and is applied to the camp fee owed. It is not in addition to the camp fee. I have read and understand the Camp Refund Policy. I understand a $25 service charge will be applied for all returned checks. Parent Signature Date
CAMPER INFORMATION:
choose a WEEK:
name: _________________________________________________________ birthdate: ________________________
____ male ____ female
select week(s) below SUPERHERO WEEK
July 2-July 7
street Address: ________________________________________________
July 9-July 14
city/st/zip: _____________________________________________________
July 16-July 21
4-H Member: Y N
July 23-July 28
How did you hear about us? _________________________________ IF Prior Camper, No. of Years? ________________________________ if referred, by whom?_________________________________________ Parent/guardian 1: ___________________________________________ phone: _______________________ alt. phone: ____________________ email:__________________________________________________________ Parent/guardian 2: ___________________________________________ phone: _______________________ alt. phone: ____________________ email: _________________________________________________________
*note: All correspondance will be by email.
Pickup authorization _________________________________________
July 30-August 4 LEADERSHIP WEEK August 6-11
Order a t-shirt: (optional, pre-order only-$10)
YOUTH 10/12 youth 14/16 adult small adult medium adult large adult x lrg Adult xx lrg
Cabin-mate request*: (must be within 2 years of age.) *Although we try to accomodate cabinmate requests, they are are NOT guaranteed.
enroll online:
www.CampWyomoco.com
activities: (AQ) Aquatics (AR) Archery (BT) BOATING (EC) Ecology & Nature (OL) Outdoor Skills (PA) Performing Arts (sp) Sports (VA) Visual Arts counselor in training (cit1) c.I.T. - 1 (AGE 14 by 7/1/17) (cit2) c.I.T. - 2 (AGE 15 by 7/1/17) (cit3) c.I.T. - 3 (AGE 16 by 7/1/17) horse programs: (hs) horse activity (wks 2-5)-$125 (HF) horse focus (wk 4 and 5)-$175 horse camp (wk 1 only) (hc) bring a horse - $150 (rh) rent a horse - $200 use the codes above to choose your top choices for activities.
1 ________ 2 ________ 3 ________ 4 ________
2017 camp registration fees 2017 Weekly Fees: $345/week Pre-Order T-Shirt (optional) $10 Horse Program Fees (from above) Total 2017 CAMP FEES: Wyoming Cty 4-H member - -$50/week Other Cty 4-H member -$25/week Day Camp Discount-$25/week Early Bird- (before 4/15) -$25/week Multiple Week Discount-$50/addt’l week 4-H Cookie Campership Credits Total 2017 DISCOUNTS:
TOTAL 2017 fees DUE: refund policy & Parent authorization Before the start of camp:
PAYMENTS required with registration:
Any unpaid balance must be received prior to camp session. Non-Refundable Deposit Horse Fees (payment must be included with registration) Camp T-Shirt (payment must be included with registration) Additional Payment (optional)
$100
Amount PAID WITH REGISTRATION: PAYMENT ENCLOSED bill credit card:
Name on card Card Number Exp. Date: Signature
CSC Code: Date
Authorized Amount
e, minus the deposit, will be refunded. A letter from a balance, minus the deposit, will be refunded. Refunds for the balance of the camp fee, less the deposit, are made ONLY for cancellations received in writing at least three weeks prior to the opening day of the camp session. During camp: of the camp period will be made on a prorated basis, minus deposit, oblem, no refund will be granted. Under no circumstances will the deposit be refunded or transferred. Parent or Legal Guardian: I have read this application, including my child’s choice of activities. By signing below, I approve of my child’s activity choices, including any additional fees that may be associated
with this registration is non-refundable and non-transferable and is applied to the camp fee owed. It is not in addition to the camp fee. I have read and understand the Camp Refund Policy. I understand a $25 service charge will be applied for all returned checks. Parent Signature Date
