SUMMER CAMP Registration Form
Hope Lutheran Church
SUMMER CAMP Registration Form Summer Camp is for children 3 years old (must be potty trained!) through those entering 5th grade. 1. Child’s Name:
Goes By:
Age: ___
Last grade completed: __ Allergies or other medical conditions: 2. Child’s Name:
Goes By:
Age: ___
Last grade completed: __ Allergies or other medical conditions: 3. Child’s Name:
Goes By:
Age: ___
Last grade completed: __ Allergies or other medical conditions: (Please complete new form if you have more than three children to register) Parent/s:
Cell or Work #:
Street address: City:
State:
Home telephone: (
)
Zip:
e-mail address:
In case of emergency, contact:
Phone:
I will be riding with my friend (name): The following people have permission to pick my child up: FULL DAY PROGRAM (7:30AM TO 6:00PM) M-F $100 per week HALF DAY PROGRAM (7:30AM TO 12:30PM or 1:00PM TO 6:00PM) M-F $60 per week There is a $5.00 charge for every 5 minutes you are late for pick up. My child will attend the weeks of: ____ June 5 ____ June 12 ____ June 19 ____ June 26 ____ July 5-7 ____ July 10 ____ July 17 ____ July 24 We offer Vacation Bible School the Week of June 26th and your child will participate in this program automatically. Payment for the week is due Monday mornings. No refunds for days missed. Payment Options: Cash, Check, Automatic Payment On-Line at hopeoforlando.org, ($25 NSF Charge)
No Summer Camp on Monday and Tuesday, July 3rd and 4th
SUMMER CAMP ENDS ON JULY 28th, 2017 Return completed Registration Form to:
Hope Lutheran Church, 2600 N. Dean Road, Orlando, FL 32817 www.hopeoforlando.org
Phone: 407-657-4556
SUMMER CAMP Registration Form Summer Camp is for children 3 years old (must be potty trained!) through those entering 5th grade. 1. Child’s Name:
Goes By:
Age: ___
Last grade completed: __ Allergies or other medical conditions: 2. Child’s Name:
Goes By:
Age: ___
Last grade completed: __ Allergies or other medical conditions: 3. Child’s Name:
Goes By:
Age: ___
Last grade completed: __ Allergies or other medical conditions: (Please complete new form if you have more than three children to register) Parent/s:
Cell or Work #:
Street address: City:
State:
Home telephone: (
)
Zip:
e-mail address:
In case of emergency, contact:
Phone:
I will be riding with my friend (name): The following people have permission to pick my child up: FULL DAY PROGRAM (7:30AM TO 6:00PM) M-F $100 per week HALF DAY PROGRAM (7:30AM TO 12:30PM or 1:00PM TO 6:00PM) M-F $60 per week There is a $5.00 charge for every 5 minutes you are late for pick up. My child will attend the weeks of: ____ June 5 ____ June 12 ____ June 19 ____ June 26 ____ July 5-7 ____ July 10 ____ July 17 ____ July 24 We offer Vacation Bible School the Week of June 26th and your child will participate in this program automatically. Payment for the week is due Monday mornings. No refunds for days missed. Payment Options: Cash, Check, Automatic Payment On-Line at hopeoforlando.org, ($25 NSF Charge)
No Summer Camp on Monday and Tuesday, July 3rd and 4th
SUMMER CAMP ENDS ON JULY 28th, 2017 Return completed Registration Form to:
Hope Lutheran Church, 2600 N. Dean Road, Orlando, FL 32817 www.hopeoforlando.org
Phone: 407-657-4556
