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2016 - Camp AHA! application

Camp AHA! Application - 2016

 

Child(ren)’s name: ________________________________________  Age(s):______

Address: ____________________________________________________________

Town: ______________________________  State: _____  Zip: _______________

Phone(s): ________________  ,  _________________  E-mail: _________________

Please enroll me for the following dates:

(Circle dates and times)

___  June 15-17:                          15th, 16th, 17th                         full day              ½ day             am or pm extra hr

___  June 20- 24:        20th, 21st, 22nd, 23rd, 24th                 full day              ½ day             am or pm extra hr

___  June 27 – July 1:    27th, 28th, 29th, 30th, 1st                full day              ½ day             am or pm extra hr

___  July 5 - 8:           (closed 4th), 5th, 6th, 7th, 8th               full day              ½ day             am or pm extra hr

___  July 11 - 15:         11th, 12st,  13nd, 14rd, 15th                      full day             ½ day             am or pm extra hr

___  July 18 - 22:          18th, 19th, 20th, 21st, 22nd               full day              ½ day             am or pm extra hr

___  July 25 – 29:         25th, 26th, 27th, 28th, 29th              full day               ½ day             am or pm extra hr

___  Aug. 1 - 5:              1st,   2nd,   3rd,   4th,   5th                   full day              ½ day             am or pm extra hr

___  Aug. 8 – 12:            8th, 9th, 10th, 11th, 12th                 full day              ½ day            am or pm           

___  Aug. 15 – 19:      15th, 16th, 17th, 18th, 19th                full day               ½ day             am or pm extra hr

                                                Fees (per child): (full day is 9-4, ½ day is 4 hrs am or pm)

$125 wk/full days ($112 extra child):      
           $125 x ___ wks +   ($112 x ___ wks)         =  $________            

 $  72 wk/½ days ($65 extra child):          
           $  72 x ___  wks  + ($65 x ___ wks)         =  $_________            

 $  28 full day ($25 extra child):             
           $  28 x ___ days  +  ($25 x ___ days)        =  $_________            

$   16 half day ($14 extra child):             
           $  16 x ___ days  +  ($14 x ___ days)        =  $_________            

$      5 ($3 extra child) per extra hour (7:30-9 or 4-5:30): 
           
$5 x __ hrs + ($3 x__hrs)        =  $_________

___ mini-camp/specials: “camper extra fee”  @ $ ________        =  $________            

 ___ mini-camp/specials: “camper extra fee” @ $ ________        =  $________
 ___ mini-camp/specials: “non-camper fee”  @ $ ________        =  $__________
​ ___ mini-camp/specials: “non-camper fee”   @ $ ________        =  $________            

                                                            Sub-total:                                  $ _____________

            Less 10% if paid in full by 6/10)                                  -         $ ___________                   

Total fees due (make checks payable to Camp AHA!)              $  _____________