2018 - Camp Octorara (Octorara YMCA) Registration Form

Octorara YMCA Summer Camp 2018 Registration Form
Camper's Name:(last name, first name) EARLY BIRD PRICING before March 1st
Grade Completed 2017:
Age:
Birthdate:
3 Day Preschool-
$175.00
3 Day-K-6th Grade
$165.00
5 Day-$215
Spark Time
3 Day Camp
Preschool:
$185.00
K-6th: $175.00
5 Day Camp
$225.00
Literacy Camp $180.00
Leader In Training
$215.00
Spark Time
7:00am-9:00am 9:00am - 4:00pm 9:00am -4:00pm Octorara School District 9:00am -4:00pm 4:00pm-6:00pm
Week 1 June 11-15 □ □ □ □ □
Week 2 June 18-22 □ □ □ □ □ □
Week 3 June 25-29 □ □ □ □ □ □
Week 4 July 2-6 □ □ □ □ □ □
Week 5 July 9-13 □ □ □ □ □ □
Week 6 July 16-20 □ □ □ □ □ □
Week 7 July 23-27 □ □ □ □ □ □
Week 8 July 30-Aug. 3 □ □ □ □ □
Week 9 Aug. 6-10 □ □ □ □ □
Week 10 Aug. 13-17 □ □ □ □ □
Week 11 Aug. 20-24 □ □ □ □ □
What time do you expect to arrive at camp for pick up? 4:00 4:30 5:00 5:30 6:00
$25.00 non refundable deposit per camper, per session (week) must accompany each camper's application to be
registered for that session. Parent Initials: ___________
*Automatic Credit Card Draft payments are required. Weekly payments are deducted Sunday, two weeks before
selected week. Parent Initials: _________
Camp Changes:
I understand that weekly camp deposits are non-refundable and non-transferable. No refunds will be given. I
understand the following charges may be processed to my account: $50.00 will be applied to cancellations requested
less than seven days prior to the start of the camp session or when registration is requested less than four days prior
to the start of the session. There will be a $25.00 charge for all changes made after the original registration. Parent
Intials: _________