Summer Camp Registration 2012

Complete ONE form per Camper:
Please complete a separate form for each individual registering - you can register one camper for multiple camps on this same form.

Registration Deposit Payment: $25 per camp per child or adult camper. (You will pay the cost of the camp(s) you chose on the day you arrive at camp.)
Late Registration Fee.
There will be a late registration fee of $25 for any registration filed less than 2 weeks prior to your camp's start date.
After you submit this form, you will be taken to to the Camp Registration Deposit Payment page and secure your child's placement in the camp you chose.
PART 1: PERSONAL INFORMATION:
Name of Camper * First Last
Gender * Male Female
Phone Number * - (###) - ### ####
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Grade Completed as of 06/12 *
Birth Date * / MM / DD YYYY
Parent's Names *
Church *
Email Address *
PART 2: CAMP SELECTION

NOTE: 10% Discount for multiple camp selection/registration!

Choosing A Camp:
Curriculum and programming are adapted to the needs of children at various grade levels. Camps are identified by the grade which a child has completed as of June. We ask that each camper register for the camp that is provided for his/her particular grade level. Should you feel that your child would be better served by another camp, please enclose a written explanation along with the application for camp staff to review.
Pre-Kindergarten Half Day Camps June 28 ($15) July 12 ($15) July 19 ($15) July 26 ($15) August 2 ($15) August 9 ($15) FULL SUMMER [ All 6 Days ] ($80)
Kindergarten -2nd Grade Full Day Camps June 25 ($30) June 26 ($30) June 27 ($30) July 2 ($30) July 3 ($30) July 9 ($30) July 10 ($30) July 16 ($30) July 17 ($30) July 18 ($30) July 23 ($30) July 24 ($30) July 25 ($30) July 30 ($30) July 31 ($30) August 1($30) August 6 ($30) August 7 ($30) August 8 ($30) FULL SUMMER [ 20 Days ] ($540) PICK ANY 14 [ 14 Days ] ($390) PICK ANY 7 [7 Days ] ($195)
Kindergarten - 2nd Grade Overnighters July 2-3 ($75) July 5-6 ($75) July 23-24 ($75) *** JUST ADDED*** Aug 6-7 ($75)
3/4/5 Grade Camps Creative Arts Camp - June 24-30 ($300) Pioneer Camp - June 24-30 ($300) Mystery Camp - June 26- July 1 ($300) Short Experience - July 1-3 ($125) Beginning Adventure- July 15-20 ($300) Sports Camp - July 22-27 ($300) Mystery Camp - July 29-Aug. 3 ($300) H2O Splash Camp - Aug. 5-10 ($300) Mega Camp - Aug. 5-10 ($300)
6/7/8 Grade Camps Performing Arts Camp - June 24-30 ($340) Canoe Camp - July 1-3 ($160) Pioneer Camp - July 8-13 ($300) Trailblazers (Horse) Camp - July 8-13 ($340) Bike Trip Camp - July 15-20 ($325) Excursions Trail Camp - July 15-20 ($340) Sports Camp - July 22-27 ($300) Beach Adventure - July 22-27 ($400) Amplify Camp - July 29- Au. 3 ($340) Wildlife Camp - July 29- Au. 3 ($300)
8th - 12 Grade Camps Performing Arts Camp - June 24-30 ($340) Canoe Camp - July 1-3 ($160) Excursions Trail Camp - July 8-13 ($340) Bike Trip - July 15 -20($325) Beach Adventure Camp -July 22 - 27 ($400) Amplify - July 29- Aug. 3 ($340)
Family Camp (Call Camp for Prices) Family Camp (August 3-5)
FAMILY CAMP INFO: If you are registering for Family Camp, please enter the names and ages of each member attending below
Name of Person 1 First Last
Age
Name of Person 2 First Last
Age
Name of Person 3 First Last
Age
Name of Person 4 First Last
Age
Name of Person 5 First Last
Age
Name of Person 6 First Last
Age
Name of Person 7 First Last
Age
Name of Person 8 First Last
Age
FAMILY CAMP LODGING: If you are registering for Family Camp please select what lodging facility you would like to stay at:
Family Camp Lodging Options Harmony House Cabin Camping
PART 3: T-SHIRTS

*Every camper will receive a FREE T-Shirt with registration. Please select your size below.
Youth Sizes Small Medium Large
Adult Sizes Small Medium Large X-Large XX-Large
PART 4: CAMP ASSIGNMENT

*Must appear mutually on each campers registration form. No changes will be made on the day of registration.
I wish to be assigned to the same cabin as:

Campers should only request one friend to be in their cabin. If the requests are mutual (written on both applications) and for the same camp, we will do our best to accommodate them. If there is a group of 3 who wish to be together, we will consider that request, however, groups of 4 or greater will be separated.
PART 5: CONGREGATION ASSISTED BILLING

To be completed ONLY if the local congregation is to be billed for any portion of the Camp Registration

Congregation is billed only after an individual attends camp
Total amount to be billed to the church $ . Dollars Cents
Approved by (Pastor or Camp Representative)
PART 7: SIGNATURE AND DATE
In signing this application, I grant permission for my child to attend Camp Harmony and for Camp Harmony to use images (photo, video, etc) of my child and members of my family in camp publicity (print ads, internet, etc.) I wave the right to inspect or approve photos for such purpose.
Signature (Your Typed Name Serving As Your Signature) *
Today's Date * / MM / DD YYYY
NOTE: Print this page for your records before submitting this camp registration form.

Summer Camp Registration 2012

Summer Camp Registration 2012

FAMILY CAMP INFO: If you are registering for Family Camp, please enter the names and ages of each member attending below

FAMILY CAMP LODGING: If you are registering for Family Camp please select what lodging facility you would like to stay at:

PART 3: T-SHIRTS

PART 4: CAMP ASSIGNMENT

PART 5: CONGREGATION ASSISTED BILLING

NOTE: Print this page for your records before submitting this camp registration form.