please print and fill out completely
Maine East – Summer Sports Camp Registration – 2015 2601 W. Dempster St., Park Ridge, Illinois 60068 ▪ Athletic Office Fax ▪ 847.692.8293 Steve Schanz – Summer Camp Director Karen Schneider, Summer Camp Registrar ▪ Phone * 847.692.8291 ** PLEASE PRINT & FILL OUT THIS FORM COMPLETELY **- ONE FORM PER PARTICIPANT
Registration Deadline is: Thursday, June 18th
Last Name High School Student ID #
First Name
Male
Female
Address
Grade Level for next Fall - 2015: (Circle one) 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th City/Zip Code Jr. High or Elementary School attending
Home Phone
Name of Parent/ Guardian
Camps Registering for: 1st Camp $ → → → Multi-Camp Discount(s) Applied: No Discount Applied with → → → one camp Fee Waiver - Full / Reduced Lunch Cash or Check # Discount = -50% / -33.3% Credit Card Type : Credit Card Number: □ Visa □ MC For Credit Card Payment: Authorized Signature
2nd Camp -$10 = Discount For office use: Receipt #
3rd Camp $
-$10 = Discount Total Amount Due:
$ $
Expiration Date:
Please note: Incoming freshman must be registered at Maine East High School to attend Summer Camps as required per IHSA rules. Payment Payment due at time of registration. Checks payable to: Maine East High School. *Please include your Student’s ID # on all checks.* Registration Forms may be returned by mail, faxed to (847-692-8293) or dropped off at the Athletic Office or Main Office in school. Refund Policy Tuition refunds will not be made after the first day of camp. Registration fee of $15 per camp is non-refundable. Fee Waivers Discounts are available to District high school students who qualify for Fee Waivers. Sorry, incoming freshman are NOT eligible for this discount. Camp fee can be reduced by 50% (up to $60.00 maximum reduction per camp). Contact the Summer Camp Registrar for details – 847-692-8291. Multi-Camp Discounts $10.00 per camp discounts are available to participants who participate in more than one camp . . . that has a camp fee. Consent All Students must have Parent/Guardian permission to participate in the summer camps listed above. Parent/Guardian realizes that such activities involve the potential for injury to Student. Parent/Guardian acknowledges that despite the best coaching, use of advanced protective equipment, and strict observance of rules, injuries to Student are possible.
Parent /Guardian Consent: ____________________________________ Date: ____________________
Registration Deadline is: Thursday, June 18th
Last Name High School Student ID #
First Name
Male
Female
Address
Grade Level for next Fall - 2015: (Circle one) 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th City/Zip Code Jr. High or Elementary School attending
Home Phone
Name of Parent/ Guardian
Camps Registering for: 1st Camp $ → → → Multi-Camp Discount(s) Applied: No Discount Applied with → → → one camp Fee Waiver - Full / Reduced Lunch Cash or Check # Discount = -50% / -33.3% Credit Card Type : Credit Card Number: □ Visa □ MC For Credit Card Payment: Authorized Signature
2nd Camp -$10 = Discount For office use: Receipt #
3rd Camp $
-$10 = Discount Total Amount Due:
$ $
Expiration Date:
Please note: Incoming freshman must be registered at Maine East High School to attend Summer Camps as required per IHSA rules. Payment Payment due at time of registration. Checks payable to: Maine East High School. *Please include your Student’s ID # on all checks.* Registration Forms may be returned by mail, faxed to (847-692-8293) or dropped off at the Athletic Office or Main Office in school. Refund Policy Tuition refunds will not be made after the first day of camp. Registration fee of $15 per camp is non-refundable. Fee Waivers Discounts are available to District high school students who qualify for Fee Waivers. Sorry, incoming freshman are NOT eligible for this discount. Camp fee can be reduced by 50% (up to $60.00 maximum reduction per camp). Contact the Summer Camp Registrar for details – 847-692-8291. Multi-Camp Discounts $10.00 per camp discounts are available to participants who participate in more than one camp . . . that has a camp fee. Consent All Students must have Parent/Guardian permission to participate in the summer camps listed above. Parent/Guardian realizes that such activities involve the potential for injury to Student. Parent/Guardian acknowledges that despite the best coaching, use of advanced protective equipment, and strict observance of rules, injuries to Student are possible.
Parent /Guardian Consent: ____________________________________ Date: ____________________
