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SRK Summer Camp Registration Form

 
Fill out this on-line form to register your child for SRK Summer Camp. After filling in all the information, you will then be given an opportunity to either continue your order on-line and pay via PayPal/Credit card, or to mail in your payment using a personal check or money order.
 

*Parent #1 Info:

*P1 Name:

*P1 Home Phone: 

*P1 Cell Phone: 

Parent #2 Info:

P2 Name: 

P2 Home Phone: 

P2 Cell Phone: 

*Home Address:

*Address:

*City:  *State:   *Zip: 

*email Address:
(we will email you confirmation papers)

*Child #1:

 

*Name:

*Age at Camp:

*Date of Birth: 

*Grade: 

Health/Allergy concerns?

Other Concerns? 

* How many weeks per child would you like to enroll?
(minimum 2 weeks per child): 
Please check the weeks below that you want this child to attend.

   Week 1 – * June 1 to June 4

   Week 2 – June 7 to June 11

   Week 3 – June 14 to June 18

   Week 4 – June 21 to June 25

   Week 5 – June 28 to July 2

   Week 6 – * July 6 to July 9

   Week 7 – July 12 to July 16

   Week 8 – July 19 to July 23

   Week 9 – July 26 to July 30

   Week 10 – Aug 2 to Aug 6

* Please note Monday 5/31 & 7/5 are closed due to observance of Holidays

Child #2:

 

 Name:

Age at Camp:

Date of Birth: 

Grade: 

Health/Allergy concerns?

Other Concerns? 

How many weeks per child would you like to enroll?
(minimum 2 weeks per child):    
Please check the weeks below that you want this child to attend.

   Week 1 – * June 1 to June 4

   Week 2 – June 7 to June 11

   Week 3 – June 14 to June 18

   Week 4 – June 21 to June 25

   Week 5 – July 28 to July 2

   Week 6 – * July 6 to July 9

   Week 7 – July 12 to July 16

   Week 8 – July 19 to July 23

   Week 9 – July 26 to July 30

   Week 10 – Aug 2 to Aug 6

* Please note Monday 5/31 & 7/5 are closed due to observance of Holidays

Child #3:

 

Name:

Age at Camp:

Date of Birth: 

Grade: 

Health/Allergy concerns?

Other Concerns? 

How many weeks per child would you like to enroll?
(minimum 2 weeks per child):   
Please check the weeks below that you want this child to attend.

   Week 1 – * June 1 to June 4

   Week 2 – June 7 to June 11

   Week 3 – June 14 to June 18

   Week 4 – June 21 to June 25

   Week 5 – June 28 to July 2

   Week 6 – * July 6 to July 9

   Week 7 – July 12 to July 16

   Week 8 – July 19 to July 23

   Week 9 – July 26 to July 30

   Week 10 – Aug 2 to Aug 6

* Please note Monday 5/31 & 7/5 are closed due to observance of Holidays

*Who may pick up the children?

Check programs you are interested in:

Sports Camps   Extended Care   Hot Lunches   SRK After-School Program

Referral Info:

Friends that go to SRK or that referred you?  

Are you a resident of Heritage Harbor?                   Yes           No
Heritage Harbor residents get $10.00 discount per week on Summer Camp Rates

*Payment Method:

   I will mail in my paperwork along with a Check or Money Order

   I will process my Payment on-line from this website using PayPal, Credit or Debit Card. I understand there is a 3.5% processing fee to pay using this method.

Payments

  1. SRK Camp offers payment plans; each Child's Camp fees must be paid 2 weeks in advance of enrolled week. You must be paid 2 weeks ahead of time to hold your child's weeks of camp.
  2. Payments can be made bi-weekly or monthly.
  3. Enrollment is easy, send in your enrollment forms with a 2 week's deposit plus the $35 enrollment fee per child and you are all set. ****If you wish, you may pay in full at any time.
  4. Payment Options: Cash, check, money order or credit cards via our Paypal link on our website, please note there is a 3.5% processing fee for this option.

Cancellations/Discounts

  • I understand that the weeks of enrollment I have selected are reserved for my child and other children may be turned away. Any requests to change a reserved week, must be submitted to and approved by the Camp Director via email/text. I understand that my request may not be granted due to space availability and unless my child's spot can be filled a refund/credit will not be issued.

Hours of Operation

  1. Standard Hours for camp are 8:45am to 4:30pm. You may sign up for early drop off and late pick up (7:30am – 6:00pm) for an additional $20.00 per week/per child.

Lunch/Field Trips/Adventure Week

  1. Please send a packed lunch & snacks from home. Make sure children have a refillable water bottle and mask with name on it.
  2. Field Trips will require additional fees, which include transportation. Payment and signed permission slips are required in advance of scheduled field trip.
  3. Adventure Weeks are for Children entering 5th grade and higher only. Field Trips are Monday through Thursday weather permitting. Friday is utilized as a make up day for inclement weather.

Waivers

  1. I understand that my child's photograph may be taken during his/her participation at SRK Camp and I give my authorization for SRK Camp to display said photos in the classroom, our Facebook Page and on the SRK Camp website.
  2. I grant permission for my child to ride in SRK Camp approved vehicles for daily transportation to and from field trips, parks, game fields and other SRK Camp locations, etc.

Parent’s Authorization

  • This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed camp activities, and I understand that I must provide the signed consent & medical waivers on my Childs first day of camp.   Note:  You will be directed to the forms at the end of your enrollment selection.

    I understand that if I enroll via PayPal on-line and use a debit or credit card, that I am being charged a 3.5 % processing fee.
 
 
 
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