CAMP ReGISTRATION FORM - International School of Indiana
CAMP ReGISTRATION FORM - International School of Indiana
CAMP ReGISTRATION FORM - International School of Indiana
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ISI Summer Camp Program<br />
Registration Form<br />
Camper Name: _____________________________________________________________________________<br />
Date <strong>of</strong> Birth:_________________________ Age:____________________ Grade Next Fall:_______________<br />
Current <strong>School</strong>: _____________________________________________________________________________<br />
Parent(s) Name(s): ___________________________________________________________________________<br />
Home Address: ______________________________________________________________________________<br />
Parent Cell Number:_____________________________ Alt. Number: _________________________________<br />
Parent Email Address:_________________________________________________________________________<br />
Indicate Camps you would like your child to register for:<br />
Camp Name Camp #<br />
_____________________________________________________________________________________ $150<br />
_____________________________________________________________________________________ $150<br />
_____________________________________________________________________________________ $150<br />
_____________________________________________________________________________________ $150<br />
m Eligible for ISI Family Discount ($25 <strong>of</strong>f per camp) Use Coupon Code ISI<strong>CAMP</strong> (discount does not apply to extended care)<br />
Indicate if you would like to sign up your child for Extended Care: ($50 per session)<br />
m #045 June 17 – June 21; 7am – 9am m #047 June 24 – June 28; 7am – 9am<br />
m #046 June 17 – June 21; 4pm – 6pm m #048 June 24 – June 28; 4pm – 6pm<br />
Please complete payment online at: http://store.isind.org/ISI-Camps-C9.aspx<br />
Or send check payable to:<br />
ISI Summer Camp to <strong>International</strong> <strong>School</strong> <strong>of</strong> <strong>Indiana</strong>, 4330 Michigan Rd, <strong>Indiana</strong>polis, IN 46208<br />
The following adults have my permission to pick up my child from camp (include relationship to child):<br />
____________________________________________________________________________________<br />
____________________________________________________________________________________<br />
____________________________________________________________________________________<br />
I have read, completed, understood and agree to abide by the <strong>International</strong> <strong>School</strong> <strong>of</strong> <strong>Indiana</strong>’s:<br />
m Participation Agreement<br />
m Medical Emergency Form and Release<br />
m Participation Waiver and Release <strong>of</strong> Liability<br />
____________________________________________________________________________________<br />
Mother and/or Guardian <strong>of</strong> Camper’s Signature<br />
Date<br />
____________________________________________________________________________________<br />
Father and/or Guardian <strong>of</strong> Camper’s Signature<br />
Date