2017 Summer Camp Schedule
2017 Summer Camp Schedule $65 Early Bird Discount: Register before March 31st $40 Discount for everyone who registers in the month of April Sibling Discount: $25/child discount that can be applied to all siblings registering for summer camp at PYC in the year 2017.
Week 1: July 2nd – 7th Friendship 1 Explorer 1 Mini Camp Week 2: July 9th – 14th Pioneer 1 Explorer 2 Day Camp 1 Week 3: July 16th – 21st Friendship 2 Extreme Explorer Day Camp 2 Week 4: July 23rd – 28th Pioneer 2 Teen Explorer Middle School Art Camp Day Camp 3 Week 5: July 30th – August 4th Teen Camp Teen Art Camp Week 6: August 6th – 12th Adirondack Adventure Camp
Dates: July 2-7 July 2-7 July 6-7
Ages: 8-10 11-13 6-8
Cost $324 $374 $175
July 9-14 July 9-14 July 10-14
11-13 11-13 5-7
$324 $374 $224
July 16-21 July 16-21 July 17-21
8-10 12-14 8-10
$324 $374 $224
July 23-28 July 23-28 July 23-28 July 24-28
11-13 14-18 11-13 5-7
$324 $374 $349 $224
July 30-Aug. 4 July 30-Aug. 4
14-18 14-18
$324 $349
Aug. 6-12
14-18
$424
Penn-York Camp & Retreat Center 2017 Summer Camp Registration Form: Or register online at www.pennyork.com/register Camper Information: Camp of Choice_____________________________________________ Camp Dates _____________________ Camper Name______________________________________________________________________________ Camper D.O.B. ____________________________________ Gender: Male Female Camper E-mail_____________________________________ Camper T-shirt size: Youth: M L Adult: S M L XL Guardian Information: Guardian One______________________________________________________________________________ Guardian Two______________________________________________________________________________ Address___________________________________________________________________________________ City____________________________________________________State____________Zip________________ Phone #________________________Cell #________________________Email__________________________ Emergency Contact Information: *Emergency Contact Name____________________________________________________________________ Phone #_______________________________________ Cell # _______________________________________ Relation to Camper __________________________________________________________________________ *Emergency Contact – Other than parent or guardian - Unless instructed otherwise, Penn-York Camp will always contact the guardians in the event of an emergency. The emergency contact will only be called if the camp is unable to reach the guardians.
Church Information: Church Affiliation ___________________________________________________________________________ Address ___________________________________________________________________________________ Pastor_____________________________________________________________________________________ Health Report: Please list any health considerations or special needs that the camper may have. Please include any allergies. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Is the camper up to date on tetanus booster and immunizations: YES NO Intending to be legally bound, I declare that the above information is current and accurate to the best of my knowledge. Print Name of Guardian_______________________________________________________________________ Signature of Guardian______________________________________________Date______________________ Extras: Optional Cabin Mate Request________________________________________________________ (No guarantees) Check if you prefer PYC to send you hard copies of receipts and info packets via mail instead of email.
Continue on next page
Penn-York Camp & Retreat Center 2017 Summer Camp Registration Form: Or register online at www.pennyork.com/register Payment Worksheet: Charges Cost of Camp Additional Store** (All campers start with a credit of $10) Total Charges Discounts*** Early Bird Discount Sibling Discount Campership Discount Total Discounts Totals Total Charges Minus Total Discounts Total Cost of Camp* Total Cost Paid At This Time (minimum of $25 to secure registration)
$ $ $ $ $ $ $ $ $ $ $
*Total Cost of Camp – Penn-York Camp asks that a $25 non-refundable minimum deposit be paid to secure a spot for your child. The minimum deposit must be paid, before any discounts can be applied to your child’s account. The remaining balance is due 21 days prior to when the camp starts. ** Additional Store – All campers start off with $10 in their camp store account. Campers automatically receive this $10 as part of the cost of registration. Additional store money can be added to the existing $10. Additional money that is not used up by then end of camp will be refunded. Please note, camp does not refund the $10 that comes as part of the registration cost. ***Discounts Early Bird Discount Register and pay $25 before March 31st to receive a $65 discount Register and pay $25 during the month of April to receive a $40 discount Sibling Discount When the $25 non-refundable minimum deposit is paid, the sibling discount of $25/child can be applied to all siblings registering for summer camp at PYC in the year 2017. Campership Discount We don't want any child to miss camp because it costs too much. These discounts are to help assist, if you are unable to pay for the entire cost of camp. If you need assistance with the cost of camp, please don't hesitate to request a discount. When the $25 non-refundable minimum deposit is paid, you can ask for either a $50 discount or a $100 discount, and camp will approve it with no questions asked. If needed, more financial assistance is available. Please call our office.
Payment by Credit Card Visa
MasterCard
Discover
CC#_______________________________________ Exp. Date
Security Code
Amount Charged
_________
_________
$_____________
Name: (As Appears on Card) __________________________________________
Penn-York Camp & Retreat Center 266 Northern Potter Rd. Ulysses, PA 16948 814-848-9811 [email protected] www.pennyork.com
Week 1: July 2nd – 7th Friendship 1 Explorer 1 Mini Camp Week 2: July 9th – 14th Pioneer 1 Explorer 2 Day Camp 1 Week 3: July 16th – 21st Friendship 2 Extreme Explorer Day Camp 2 Week 4: July 23rd – 28th Pioneer 2 Teen Explorer Middle School Art Camp Day Camp 3 Week 5: July 30th – August 4th Teen Camp Teen Art Camp Week 6: August 6th – 12th Adirondack Adventure Camp
Dates: July 2-7 July 2-7 July 6-7
Ages: 8-10 11-13 6-8
Cost $324 $374 $175
July 9-14 July 9-14 July 10-14
11-13 11-13 5-7
$324 $374 $224
July 16-21 July 16-21 July 17-21
8-10 12-14 8-10
$324 $374 $224
July 23-28 July 23-28 July 23-28 July 24-28
11-13 14-18 11-13 5-7
$324 $374 $349 $224
July 30-Aug. 4 July 30-Aug. 4
14-18 14-18
$324 $349
Aug. 6-12
14-18
$424
Penn-York Camp & Retreat Center 2017 Summer Camp Registration Form: Or register online at www.pennyork.com/register Camper Information: Camp of Choice_____________________________________________ Camp Dates _____________________ Camper Name______________________________________________________________________________ Camper D.O.B. ____________________________________ Gender: Male Female Camper E-mail_____________________________________ Camper T-shirt size: Youth: M L Adult: S M L XL Guardian Information: Guardian One______________________________________________________________________________ Guardian Two______________________________________________________________________________ Address___________________________________________________________________________________ City____________________________________________________State____________Zip________________ Phone #________________________Cell #________________________Email__________________________ Emergency Contact Information: *Emergency Contact Name____________________________________________________________________ Phone #_______________________________________ Cell # _______________________________________ Relation to Camper __________________________________________________________________________ *Emergency Contact – Other than parent or guardian - Unless instructed otherwise, Penn-York Camp will always contact the guardians in the event of an emergency. The emergency contact will only be called if the camp is unable to reach the guardians.
Church Information: Church Affiliation ___________________________________________________________________________ Address ___________________________________________________________________________________ Pastor_____________________________________________________________________________________ Health Report: Please list any health considerations or special needs that the camper may have. Please include any allergies. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Is the camper up to date on tetanus booster and immunizations: YES NO Intending to be legally bound, I declare that the above information is current and accurate to the best of my knowledge. Print Name of Guardian_______________________________________________________________________ Signature of Guardian______________________________________________Date______________________ Extras: Optional Cabin Mate Request________________________________________________________ (No guarantees) Check if you prefer PYC to send you hard copies of receipts and info packets via mail instead of email.
Continue on next page
Penn-York Camp & Retreat Center 2017 Summer Camp Registration Form: Or register online at www.pennyork.com/register Payment Worksheet: Charges Cost of Camp Additional Store** (All campers start with a credit of $10) Total Charges Discounts*** Early Bird Discount Sibling Discount Campership Discount Total Discounts Totals Total Charges Minus Total Discounts Total Cost of Camp* Total Cost Paid At This Time (minimum of $25 to secure registration)
$ $ $ $ $ $ $ $ $ $ $
*Total Cost of Camp – Penn-York Camp asks that a $25 non-refundable minimum deposit be paid to secure a spot for your child. The minimum deposit must be paid, before any discounts can be applied to your child’s account. The remaining balance is due 21 days prior to when the camp starts. ** Additional Store – All campers start off with $10 in their camp store account. Campers automatically receive this $10 as part of the cost of registration. Additional store money can be added to the existing $10. Additional money that is not used up by then end of camp will be refunded. Please note, camp does not refund the $10 that comes as part of the registration cost. ***Discounts Early Bird Discount Register and pay $25 before March 31st to receive a $65 discount Register and pay $25 during the month of April to receive a $40 discount Sibling Discount When the $25 non-refundable minimum deposit is paid, the sibling discount of $25/child can be applied to all siblings registering for summer camp at PYC in the year 2017. Campership Discount We don't want any child to miss camp because it costs too much. These discounts are to help assist, if you are unable to pay for the entire cost of camp. If you need assistance with the cost of camp, please don't hesitate to request a discount. When the $25 non-refundable minimum deposit is paid, you can ask for either a $50 discount or a $100 discount, and camp will approve it with no questions asked. If needed, more financial assistance is available. Please call our office.
Payment by Credit Card Visa
MasterCard
Discover
CC#_______________________________________ Exp. Date
Security Code
Amount Charged
_________
_________
$_____________
Name: (As Appears on Card) __________________________________________
Penn-York Camp & Retreat Center 266 Northern Potter Rd. Ulysses, PA 16948 814-848-9811 [email protected] www.pennyork.com
