FAMILY ADVENTURE STARTS HERE

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "FAMILY ADVENTURE STARTS HERE"

Transcription

1 FAMILY ADVENTURE STARTS HERE YMCA FAMILY CAMP AT SEQUOIA LAKE THIS SUMMER! Family Camp promises to be a week of adventure and fun for the entire family. Your family will enjoy hiking, swimming, canoeing, rock climbing, fishing, campfires, relaxing and more! Price includes six nights lodging, all meals, individual and family activities on beautiful Sequoia Lake, a privately owned YMCA camp approximately one mile outside of Sequoia and Kings Canyon National Park. Dates: August 9-15, 2014 Cost: $1,455-$2,380/week (varies by accommodation) Financial Assistance is available. Contact: Eliot Bertha ext. 259 SANTA BARBARA FAMILY YMCA a branch of the Channel Islands YMCA 36 Hitchcock Way, Santa Barbara CA ciymca.org

2 February 2014 Dear Families, It is with great excitement that I give you your Family Camp Registration Packet for the summer of 2014! Please review this entire letter and its contents before returning the registration form with your deposit beginning March 1, In order for us to be able to offer family camp this year, you will find we changed our pricing structure. We hope this will not deter anyone from attending and will allow us to meet the expenses of camp. Please remember that reservations for camp are on a first-come, first-serve basis. This year, like every year, there are many families who will be returning to camp with their lodging requests already in mind. Please be sure to get all of your registration materials and deposit returned in a timely manner to secure your spot. Sharing of cabins is encouraged due to the demands of space and the new pricing structure. Please think of this possibility to ensure your family attains the accommodations requested. We will be happy to assist you with this request. Camp Dates: Saturday, August 9- Friday, August 15, 2014 Cost: To Register: New this year; price is based on your accommodation for the week. Please see attached for accommodation details and legend. Camp map is also enclosed. 1. Complete the enclosed Registration Packet 2. Send or drop off your registration with your deposit of $400 per accommodation to: Santa Barbara Family YMCA Attn: Eliot Bertha 36 Hitchcock Way Santa Barbara, CA OR 3. or Fax to your registration and credit card information for deposit or payment. Deposits are non-transferable and non-refundable Your remaining balance is due by June 1, We hope camp will fill up quick, so do not hesitate to secure your spot on the lake! If you have any questions, please call me at , ext We hope to see your registration soon. Thanks! Sincerely, Eliot Bertha Family Camp Director

3 FAMILY CAMP INFORMATION SHEET Family Camp Sequoia-All ages: children under age 18 must be accompanied by an adult Dates: August 9-15, 2014 (Saturday- Friday) Cost: Based on Accommodation for week $1,455-$2,380 What: An exclusive week of Santa Barbara YMCA Family Camp for all ages at Camp Sequoia. Price includes 6 days and 6 nights lodging, all meals, individual and family activities on beautiful Sequoia Lake and in Sequoia and Kings Canyon National Park mountains. Come renew your spirit and challenge your sense of wonder. Experience an epic week of whatever you need for you and your family! Locations and Activities: YMCA Camp Sequoia, a privately owned YMCA camp approximately 1 mile outside of Sequoia National Park, is located on Lake Sequoia. Days will be filled with hiking, swimming, boating, fishing, games, crafts, and campfires. Karaoke, Teen hike and overnight, and other fun, family strengthening special events will fill the week. Kid s camp will take place on most mornings for 2 hours by trained YMCA staff. Transportation: Families will provide their own transportation to camp. Accommodations: This year you will be paying per accommodation. The cost is based on a family of 4. If you have fewer than 4, you will want to consider joining another family; if more than 4 an additional charge of $371 will be added per camper age 4 and older. For basic information on accommodations please refer to the registration packet. For specifics on the different accommodations, families should contact Eliot Bertha at ext Meals: The camp prepares meals. Three meals a day will be provided (except the first and last day of camp). They are basic meals. If you have any special dietary concerns, please note them on your registration form. All families will share in KP duty. It is suggested that you bring supplemental snacks for your family. Camp Rally: Thursday, July 24, 2014 from 6:00-7:00 pm at the Santa Barbara Family YMCA. The camp rally is very important for both new and returning campers. The evening is filled with essential, last minute details. Don t miss it! What to bring: Keep your eye out for this list with your accommodation confirmation letter once your deposit is received. Registration and Camp Packet: Registrations will be accepted beginning March 3, 2014 at the Santa Barbara Family YMCA. A non-refundable/non-transferable $400.00/accommodation deposit is required to save a space. Space is limited and can only be reserved with a deposit. Your balance is due no later than June 1, All forms are due 2 weeks prior to camp. Changes: Although unlikely, the YMCA reserves the right to cancel a camp due to lack of enrollment or change the dates and locations. In the event of a cancelled camp, refunds will be given of all camp fees paid. Any other info or questions: Contact Eliot Bertha at , ext. 259.

4 ACCOMODATION INFORMATION Apartment (A) has 4 rooms including a private bath with a toilet, shower and sink, a living room, and two bedrooms that each has a queen-sized bed and a bunk-style bed. Apartments house up to 6-8 people each. $2,380 Winterized cabin (W) is an A-frame with a partial wall that divides the cabin into a front area with one queensized bed and a back area with three bunk-style beds, stands alone and is insulated. Winterized cabins house up to 6 people each. $2,115 Quad/Duplex (X) shares a common wall with one other cabin, has four bunk-style beds, and is insulated. Two beds can be combined for a queen. Duplex cabins house up to 5 people each. $1,590 Divided cabin (D) stands alone; has a partial wall that divides the cabin into a front area with one queen-sized bed and a back area with three bunk-style beds. Divided cabins house up to 4 people each. $1,760 Rustic cabin (R) stands alone (it does not share a common wall with another cabin), has four bunk-style beds and screen-covered openings for windows. Rustic cabins house up to 6 people each. $1,590 Tent site (TT) bring your own shelter. All sites have a picnic bench, a bear box, and a flat area for a tent. Some, but not all, sites can accommodate a small RV. Tent sites can house up to 6 people each. Call for RV specifications. $1,455 Restrooms and showers Restrooms and shower facilities are separate from the cabins and centrally located. Only the Apartments in Camp Sequoia have private baths.

5 Keep first 3 pages. Turn the remaining pages in to the YMCA

6 SANTA BARBARA YMCA FAMILY CAMP REGISTRATION 2014 Family Last Name: Mailing Address: City: State: Zip: Cell Phone: Emergency Contact: Important-please provide an emergency contact person: Name : Relation to family: Best Phone: Campers: Name Gender Birthdate Shirt Size Primary Contact (first and last name): LODGING REQUESTS: Because space is limited at Sequoia Lake and demand for certain accommodations is higher than others, we cannot guarantee you will be housed in your first choice. Please provide your top 3 choices for lodging accommodations. Please see the attached map and lodging descriptions. First Choice: Camp/Tent Site # Divided Cabin # Rustic Cabin # Winterized Cabin # Quad/Duplex # Apt# Second Choice: Camp/Tent Site # Divided Cabin # Rustic Cabin # Winterized Cabin # Quad/Duplex# Apt# Third Choice: Camp/Tent Site # Divided Cabin # Rustic Cabin # Winterized Cabin # Quad/Duplex# Apt# CABIN MATE REQUEST: ADDITIONAL NOTES:

7 PAYMENT WORKSHEET *Accommodation Rate (up to four family members) Tent Rustic Cabin Quad/Duplex Divided Cabin Winterized Cabin Apartment *additional camper 4 and up $1,455/week $1,590/week $1,590/week $1,760/week $2,115/week $2,380/week $371/camper TOTAL DUE FOR YOUR FAMILY: Price of accommodation: $ + additional family members ($371 per person) = DEPOSIT $ deposit per accommodation due at the time of registration (Tent, Rustic Cabin, Quad/Duplex, Divided Cabin, Winterized Cabin, Apartment) REMAINING BALANCE Total due for your family (from above) - $400 deposit = remaining balance due $ Final payments are due no later than 6/1/2014. If you wish to have monthly payments withdrawn from your account, please fill out the EFT Authorization form on the following page. A late fee of $25.00 per camper will be issued for payments made after due date. Other important information: Confirmation of registration or waiting list will be mailed to you along with camp schedule and list of what to bring. Family Camp reservation deposits are nontransferable and nonrefundable. The YMCA does not honor reservations given or sold to others.

8 CHANNEL ISLANDS YMCA PHOTO/ VIDEO RELEASE In exchange for good and valuable consideration, the adequacy of which is hereby acknowledged, I hereby give Channel Islands YMCA, its volunteers, employees and any other person and entity acting with its permission the right to take, copyright, use, and publish any photographs or video of me or my child/children for the purpose of any YMCA advertising, promotion, or other purpose consistent with the YMCA mission. I agree that any such photograph or video is the property of the Channel Islands YMCA, and I hereby waive all rights thereto. I further waive any right to inspect or approve any printed or electronic material that may be used in conjunction with the photographs or video, or to approve the use to which the photographs or video may be applied. Date Parent Name Signature (if minor child, parent or guardian signs) Parent Name Signature (if minor child, parent or guardian signs) Address Phone Number

9 CHANNEL ISLANDS YMCA MEMBER/CHILDREN RELEASE and WAIVER of LIABILITY and INDEMNITY AGREEMENT IN CONSIDERATION of being permitted to utilize the premises, facilities, services and programs of the Channel Islands YMCA, YMCA, (or for my children to so participate) for any purpose, including, but not limited to observation or use of facilities or equipment, or participation in any off-site program affiliated with the YMCA, the undersigned, for himself or herself and such participating children and any personal representatives, heirs, and next of kin, hereby acknowledges, agrees and represents that he or she has, or immediately upon entering or participating will, inspect and carefully consider such premises and facilities or the affiliated program. It is further warranted that such entry onto the YMCA s facilities for observation or use of any facilities or equipment or participation in such affiliated program constitutes an acknowledgement that such premises and all facilities and equipment thereon and such affiliated program have been inspected and carefully considered and that the undersigned finds and accepts same as being safe and reasonably suited for the purpose of such observation, use or participation by the undersigned and such children. IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE YMCA FOR ANY PURPOSE INCLUDING, BUT NOT LIMITED TO OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION 1N ANY OFF-SITE PROGRAM AFFILIATED WITH YMCA, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING: 1. THE UNDERSIGNED ON HIS OR HER BEHALF AND BEHALF OF SUCH CHILDREN, HEREBY RELEASES, WAIVES, DISCHARGES AND CONVENANTS NOT TO SUE the YMCA and all branches thereof; its directors, officers, employees, and agents (hereinafter referred to as "releasees") from all liability to the undersigned or such children and all his personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the undersigned or such children whether caused by the negligence of the releasees or otherwise while the undersigned or such children is in, upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with the YMCA. 2. THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them from any, loss, liability, damage or cost they may, incur due to the presence of the undersigned or such children in, upon or about YMCA s premises or in any way observing or using any facilities or equipment of the YMCA or participating in any program affiliated with the YMCA whether caused by the negligence of the releasees or otherwise. 3. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned or such children due to negligence of releasees or otherwise while in, about or upon the premises of the YMCA and/or while using the premises or any facilities or equipment thereon or participating in any program affiliated with YMCA. THE UNDERSIGNED further expressly agrees that the foregoing RELEASE WAIVER AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. THE UNDERSIGNED' HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducement apart from the foregoing written agreement have been made. I HAVE READ AND UNDERSTAND THIS DOCUMENT AND RELEASE Date: Print Name: Signature of Applicant/Parent: Signature of other Adult: Membership Number Name of Child in Program: Name of Child in Program: Revised May 2009 Name of Child in Program: Name of Child in Program:

10 EFT AUTHORIZATION FORM MEMBERSHIP - PROGRAM - CAMP - CHILD CARE - DONATIONS ACCOUNT HOLDER First Name Last Name Member Number Santa Barbara Family YMCA Montecito Family YMCA Lompoc Family YMCA Ventura Family YMCA Camarillo Family YMCA Stuart C. Gildred Family YMCA BANK ACCOUNT OPTION PLEASE CHECK ONE: CHECKING SAVINGS Routing Number (9 digits) Account Number CREDIT CARD ACCOUNT OPTION PLEASE CHECK ONE: VISA MC AMEX DISCOVER Account Number Expiration Date (MM/YYYY) Card Issuer / Bank Preferred day of monthly draft: 6 th 20 th I hereby authorize the Channel Islands YMCA to initiate debits to the bank account/credit cards listed on this form. The YMCA processes payments to the bank on the 6th and 20th of every month (or next business day). If we are unable to debit your account for any reason, we will automatically redraft on our next scheduled draft date. Should electronic transfer of funds be denied, account holder will be charged a processing fee of $20. Your Individual YMCA membership will automatically be adjusted at these specific ages: 19 and 66 years old. (Teen will auto upgrade to Adult, and Adult will upgrade to Senior). Please update the YMCA about any credit cards reported lost or stolen, expiration date changes and address changes. Updates must be received 10 days prior to the month of the draft to allow for processing time. The YMCA reserves the right to cancel/terminate any membership/program if a payment cannot be collected. Membership dues are collected within the current month of activity. I acknowledge that there is a 30-day notice period before a cancellation is put into effect. Therefore I must provide 30 days notice of cancellation by signing the appropriate cancellation form in person. I understand it is my responsibility to check my account for YMCA transactions. I will notify the YMCA within 60 days of the transaction date of any transaction that appears to be in error. The transaction will be investigated and corrected if necessary. I understand that I am agreeing to the terms listed in the cancellation policy of the Channel Islands YMCA. Account Holder s Signature Date FOR OFFICE USE ONLY Date: Activity: Entered by: CHANNEL ISLANDS YMCA serving Santa Barbara and Ventura counties 55 Hitchcock Way, Suite 101, Santa Barbara CA 93105

Pittsfield Family YMCA: Personal Training Services

Pittsfield Family YMCA: Personal Training Services Pittsfield Family YMCA: Personal Training Services I would like to purchase the following Client s Name personal training package with personal trainer : Trainer s Name 1 Session, $40 2 Sessions, $80 5

More information

MEMBERSHIP/BOAT SUPPORT APPLICATION

MEMBERSHIP/BOAT SUPPORT APPLICATION MEMBERSHIP/BOAT SUPPORT APPLICATION Family memberships include no more than two adults per household and their unmarried rowing children under the age of 21 (or currently enrolled in school up to age 23).

More information

2016 LakeRacer LLC Desert Storm Event Registration Forms. POKER RUN EVENT TERMS AND CONDITIONS

2016 LakeRacer LLC Desert Storm Event Registration Forms. POKER RUN EVENT TERMS AND CONDITIONS POKER RUN EVENT TERMS AND CONDITIONS The registration fees: Each entry includes Two poker hands, two t-shirts, two adult entries for the registration party, awards banquet, prize drawings, and an aerial

More information

East Hartford YMCA 770 Main St. East Hartford, CT 06108. Dear YMCA Family,

East Hartford YMCA 770 Main St. East Hartford, CT 06108. Dear YMCA Family, s Dear YMCA Family, Thank you for choosing the East Hartford YMCA for your early childhood education needs. We are excited to welcome you and your family to our program! The Y s focus is on youth development,

More information

2016 Bowdoin Summer Art Camp Registration

2016 Bowdoin Summer Art Camp Registration 2016 Bowdoin Summer Art Camp Registration Hours and Location Bowdoin Summer Art Camp will run for four weeks from June 27 th through July 22 th. The times and length of each session vary. Please refer

More information

Hornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823

Hornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823 Hornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823 Participant Last Name: Participant First Name: Grade: Age: Gender: Male

More information

Oasis Christian Youth Ministry Presents Camp H2O Summer Reading Enrichment Program 4524 East Brookstown Dr. Baton Rouge, LA 70805

Oasis Christian Youth Ministry Presents Camp H2O Summer Reading Enrichment Program 4524 East Brookstown Dr. Baton Rouge, LA 70805 Oasis Christian Youth Ministry Presents Camp H2O Summer Reading Enrichment Program 4524 East Brookstown Dr. Baton Rouge, LA 70805 Are you looking for a summer of reading enrichment and fun???? Then look

More information

Recreation & Community Services Camp Serendipity Summer Day Camp 2016

Recreation & Community Services Camp Serendipity Summer Day Camp 2016 Recreation & Community Services Camp Serendipity Summer Day Camp 2016 Camp Phone & Address Performing Arts Center (Youth Center) 800 Hobson Way (805) 385-8168 (Camp Site) (805) 890-6321 (Camp Site Cell)

More information

2015 RACE REGISTRATION packet

2015 RACE REGISTRATION packet 2015 RACE REGISTRATION packet First annual Delaware Charity Challenge Saturday, May 2, 2015 Lums Pond State Park Bear, Delaware delawarecharitychallenge.com Saturday, May 2, 2015 Lums Pond State Park 2015

More information

Santa Monica College Administrative Regulation - Students Activities and Student Conduct

Santa Monica College Administrative Regulation - Students Activities and Student Conduct Santa Monica College Administrative Regulation - Students Activities and Student Conduct (AR5319-091481) Extracurricular Trips Arrangements for trips by clubs and other non-athletic extracurricular activity

More information

3004 S. Rancho Dr. Las Vegas, NV. 89102 * PH: 702-220-5614 * www.tevakanui.com

3004 S. Rancho Dr. Las Vegas, NV. 89102 * PH: 702-220-5614 * www.tevakanui.com 2009/2010 Policy Agreement I have received a copy of the 2009/2010 studio policy and current class schedule. I agree to adhere to all studio policies as contained in this document and explained to me.

More information

Georgia Tech North Ave. NW Atlanta Ga. 30332

Georgia Tech North Ave. NW Atlanta Ga. 30332 Welcome to Fun Weird STEM Saturdays 2014 The functioning objective of Fun Weird Science STEM Saturdays is to: 1. Provide students with hands-on STEM experience; and 2. Engage students in the exciting ways

More information

Release of Liability. Printed Name of Participant:

Release of Liability. Printed Name of Participant: Release of Liability IN CONSIDERATION of being given the opportunity to participate in any USRowing activity, including scheduled, supervised club activities, and registered regattas, during the policy

More information

INDEMNITY AND HOLD HARMLESS AGREEMENT

INDEMNITY AND HOLD HARMLESS AGREEMENT MIAMI-DADE COUNTY, FLORIDA MEDICAL EXAMINER DEPARTMENT NUMBER ONE ON BOB HOPE ROAD MIAMI, FLORIDA 33136-1133 (305) 545-2400 INDEMNITY AND HOLD HARMLESS AGREEMENT A. (Insert the name) (the Agency) agree(s)

More information

WESTERN NEW YORK OFFSHORE POWERBOAT ASSOC., INC. 2015 BUFFALO POKER RUN - AUGUST 7-8, 2015

WESTERN NEW YORK OFFSHORE POWERBOAT ASSOC., INC. 2015 BUFFALO POKER RUN - AUGUST 7-8, 2015 WESTERN NEW YORK OFFSHORE POWERBOAT ASSOC., INC. 2015 BUFFALO POKER RUN - AUGUST 7-8, 2015 ASSUMPTION AND ACKNOWLEDGMENT OF RISK AND RELEASE OF LIABILITY WAIVER 1. ALL OF THE UNDERSIGNED, DO HEREBY AFFIRMATIVELY

More information

Email: bhskiforlight@gmail.com Dear Friends of Ski for Light: Come celebrate the 38th Anniversary of Black Hills Regional Ski for Light with old and new friends and continue the years of discovery, growth,

More information

Initial. Registration Packet. Summer Academy June 3 rd to August 30 th Z M G. www.zmgtennis.com. HP and TTT Registration Form 1 ZMG Tennis, LLC

Initial. Registration Packet. Summer Academy June 3 rd to August 30 th Z M G. www.zmgtennis.com. HP and TTT Registration Form 1 ZMG Tennis, LLC Registration Packet Summer Academy June 3 rd to August 30 th Z M G www.zmgtennis.com HP and TTT Registration Form 1, LLC Enrolment Process prides its self on offering everything essential in the development

More information

Dear Friends of Ski for Light:

Dear Friends of Ski for Light: Email: bhskiforlight@gmail.com Dear Friends of Ski for Light: Come celebrate our 38th Anniversary of the Black Hills Regional Ski for Light with old and new friends and continue the years of discovery,

More information

YMCA of Greater Charlotte Preschool Programs

YMCA of Greater Charlotte Preschool Programs YMCA of Greater Charlotte 2016-2017 Preschool Programs YMCA of Greater Charlotte Preschools help children ages 1-5 bloom, blossom and grow! We focus on developing the whole child physically, emotionally,

More information

APPENDIX B. Adult Check here if the intern is an adult. Minor Check here if the intern is a minor.

APPENDIX B. Adult Check here if the intern is an adult. Minor Check here if the intern is a minor. APPENDIX B Adult Check here if the intern is an adult. Minor Check here if the intern is a minor. IMPORTANT: ALL ADULT INTERNS AGREE: [Insert Name] ( Intern ), by my own request, desire to participate

More information

MAKE A SPLASH. Fall Swim Lessons ISLANDS FAMILY YMCA

MAKE A SPLASH. Fall Swim Lessons ISLANDS FAMILY YMCA MAKE A SPLASH Fall Swim Lessons ISLANDS FAMILY YMCA The Islands YMCA is proud to offer the lesson of a lifetime by teaching swimming skills! During the fall/winter we will be offering Private Swim lessons

More information

RELEASE, WAIVER OF LIABILITY, HOLD-HARMLESS AGREEMENT AND COVENANT NOT TO SUE

RELEASE, WAIVER OF LIABILITY, HOLD-HARMLESS AGREEMENT AND COVENANT NOT TO SUE RELEASE, WAIVER OF LIABILITY, HOLD-HARMLESS AGREEMENT AND COVENANT NOT TO SUE This Release, Waiver of Liability, Hold-Harmless Agreement and Covenant Not to Sue (hereinafter Agreement ) was read, understood

More information

CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING

CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING The undersigned, in consideration of being permitted to participate

More information

GATEWAY DISCOVERY CAMP

GATEWAY DISCOVERY CAMP GATEWAY DISCOVERY CAMP SUMMER 2 0 1 6 REGISTRATION FORM Gateway Science Museum will host three sessions of the Gateway Discovery Camp. All sessions run 9am to 3pm and include daily snacks and lunches.

More information

City State Zip Home Phone Priority. Place of Employment Work Phone Priority. Parent/Guardian Name Date of Birth Cell Phone/Pager Priority

City State Zip Home Phone Priority. Place of Employment Work Phone Priority. Parent/Guardian Name Date of Birth Cell Phone/Pager Priority , Camper s Last Name, First Initial YMCA of Metropolitan Washington Camp Registration Form Please print clearly. Please complete all blanks on this form. If there is a blank that is not applicable, please

More information

Prairie Flight Camp. July 19-24. Prairie School of Mission Aviation. Box 4000 Three Hills, AB, Canada T0M 2N0 403.443.2349

Prairie Flight Camp. July 19-24. Prairie School of Mission Aviation. Box 4000 Three Hills, AB, Canada T0M 2N0 403.443.2349 Prairie Flight Camp 2015 July 19-24 Box 4000 Three Hills, AB, Canada T0M 2N0 403.443.2349 Our Purpose s program exists to prepare mission-minded pilots for Global Ministry. Our graduates are currently

More information

Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code:

Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code: Registration Form Please Check: Boy Girl Age: Camper s Name: Address: City: State: Zip Code: Contact Name: Emergency Contact Number: Alt. Emergency Contact Number: E-Mail Address: Alt. Contact Name: Check

More information

Amateur Sports Team & League Liability Insurance Application -No Participant Coverage-

Amateur Sports Team & League Liability Insurance Application -No Participant Coverage- Amateur Sports Team & League Liability Insurance Application -No Participant Coverage- Name of Organization: C/O (Individual Responsible for Insurance): Mailing : City: State: Zip: Phone: ( ) Fax: ( )

More information

DATE OF BIRTH: STREET ADDRESS: CITY/STATE/ZIP:

DATE OF BIRTH: STREET ADDRESS: CITY/STATE/ZIP: Get Noticed Beach Volleyball Waiver WAIVER AND RELEASE, EXPRESS ASSUMPTION OF RISK, INDEMNITY AND HOLD HARMLESS AGREEMENT, AND GRANT OF RIGHTS NAME OF PLAYER: PLAYER AGE DATE OF BIRTH: PLAYER GRADE as

More information

Lake Burton Day Camp For Boys and Girls Ages 6-9

Lake Burton Day Camp For Boys and Girls Ages 6-9 Lake Burton Day Camp For Boys and Girls Ages 6-9 Dear Day Camp Parent- In this handbook, we want to acquaint you with the procedures and practices of our YMCA summer camp programs. Thank you for enrolling

More information

WELCOME TO Y CAMP! Virginia Summer Camps Identity Verification Commonwealth of Virginia School Entrance Health Form and Immunization Record.

WELCOME TO Y CAMP! Virginia Summer Camps Identity Verification Commonwealth of Virginia School Entrance Health Form and Immunization Record. WELCOME TO Y CAMP! The following pages are the registration materials required to complete your registration. In addition to these forms, some jurisdictions require additional forms as outlined below to

More information

Emerald Hills Junior Golf Camp - Summer 2016. 938 WILMINGTON WAY REDWOOD CITY, CA 94062 www.playemeraldhills.com E-Mail - jrgolf.ehgc@gmail.

Emerald Hills Junior Golf Camp - Summer 2016. 938 WILMINGTON WAY REDWOOD CITY, CA 94062 www.playemeraldhills.com E-Mail - jrgolf.ehgc@gmail. OUR CAMPS ARE FOR GIRLS AND BOYS (AGES 5 THRU 14) Visit our website at Junior Golf Camp (9:00am 12:30pm) We start camp early (8:45am) on Monday for check-in and orientation. The camp is designed for beginners

More information

2015 Coach E s Flagler College Basketball Camps

2015 Coach E s Flagler College Basketball Camps 2015 Coach E s Flagler College Basketball Camps Necci Brown 2015 Averaged a 31.9 field goal percentage during her career as a Saint July 13-17 Camp Registration Campers cannot be admitted without full

More information

Motorcycle RiderCourse WAIVERS

Motorcycle RiderCourse WAIVERS Motorcycle RiderCourse WAIVERS General Instructions All pages must be completed and signed. If you have any questions, call (231) 591-5819. Mail completed forms to: Motorcycle Rider Courses, Ferris State

More information

Math + Leadership Camp at CSUSM Registration Forms

Math + Leadership Camp at CSUSM Registration Forms Math + Leadership Camp at CSUSM Registration Forms CONTACT INFORMATION Math for America San Diego Email: sandiego@mathforamerica.org Phone: 858-822-6284 Registration Checklist Complete all sections of

More information

without a signed waiver Santa Fe, NM 87506 Fax: 505 820 Student Name: City: Zip: State: Physician's Name: Parent Name(s): Parent Address: City:

without a signed waiver Santa Fe, NM 87506 Fax: 505 820 Student Name: City: Zip: State: Physician's Name: Parent Name(s): Parent Address: City: Please mail application to: Las Campanas Compadres, Inc. 15 Buckskin Circle Santa Fe, NM 87506 Fax: 505 820 2709 Las Campanas Compadres, Inc. Student Application Form Please be sure to sign the waiver

More information

Vendor Information. Bully Free Future Youth Summit, C/O Operation Peace of Mind 383 Perry Street Lewisville, Texas 75057 972-221-7202

Vendor Information. Bully Free Future Youth Summit, C/O Operation Peace of Mind 383 Perry Street Lewisville, Texas 75057 972-221-7202 In Collaboration with: Co-Sponsored by: Vendor Information Bully Free Future Youth Summit, C/O Operation Peace of Mind 383 Perry Street Lewisville, Texas 75057 972-221-7202 Vendor Agreement DEADLINE FOR

More information

Capture the Paris Wow September 17th - 22nd, 2015. Welcome to Capture the Paris Wow! I look forward to this creative adventure with you in Paris.

Capture the Paris Wow September 17th - 22nd, 2015. Welcome to Capture the Paris Wow! I look forward to this creative adventure with you in Paris. Capture the Paris Wow September 17th - 22nd, 2015 Capture the Wow Registration Form Welcome to Capture the Paris Wow I look forward to this creative adventure with you in Paris. In order to secure your

More information

Shotgun Coaching Workshop Registration and Information Package

Shotgun Coaching Workshop Registration and Information Package Shotgun Coaching Workshop Registration and Information Package Edmonton Conservation Education Centre for Excellence #88, 4003 98 th Street Edmonton, Alberta, Canada T6E 6M8 Phone: (780) 466-6682 or Toll

More information

City of Kennedale c/o Art in the Park 405 Municipal Drive Kennedale, TX 76060

City of Kennedale c/o Art in the Park 405 Municipal Drive Kennedale, TX 76060 Dear Art Festival Applicant: The Art in the Park Committee and the City of Kennedale invite you to apply to participate in the Fifth Annual Art in the Park Arts Festival to be held April 4 6, 2014. Please

More information

California Polytechnic State University, Pomona Vietnamese Student Association. Family. Honor. Tradition.

California Polytechnic State University, Pomona Vietnamese Student Association. Family. Honor. Tradition. California Polytechnic State University, Pomona Vietnamese Student Association Family. Honor. Tradition. ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM Name of Activity or Event: CAL POLY POMONA VSA WINTER

More information

RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME

RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME UNDER 18 YEARS (SIGNED AND INITIALED BY PARTICIPANT AND

More information

WHEATON COLLEGE ~ Wheaton, IL July 7-11, 2014 $75 deposit due at registration $450 total if registered by 4/15 $500 total for registrations after 4/16

WHEATON COLLEGE ~ Wheaton, IL July 7-11, 2014 $75 deposit due at registration $450 total if registered by 4/15 $500 total for registrations after 4/16 : Students entering 7 th 12 th grades WHEATON COLLEGE ~ Wheaton, IL July 7-11, 2014 $75 deposit due at registration $450 total if registered by 4/15 $500 total for registrations after 4/16 Debby Albrecht

More information

49 North Winters Sport Foundation Volunteer Packet

49 North Winters Sport Foundation Volunteer Packet 49 North Winters Sport Foundation Volunteer Packet Thank you for your interest in the 49 North Winters Sport Foundation Volunteer Program. The 49 North Winters Sport Foundation has a wonderful network

More information

CAMPWOW2015. HillSpring Church Youth and Children s 2015 Summer Camp Information Packet. What to Pack/What Not to Pack.

CAMPWOW2015. HillSpring Church Youth and Children s 2015 Summer Camp Information Packet. What to Pack/What Not to Pack. HillSpring Church Youth and Children s 2015 Summer Camp Information Packet Page 2 Camp WOW Summer Camp Dates and Cost Page 3 Info about Laser Tag and Camp WOW Cash Card Page 4 What to Pack/What Not to

More information

2015 ADF School Medical/Insurance Information & Liability Waivers INSURANCE INFORMATION

2015 ADF School Medical/Insurance Information & Liability Waivers INSURANCE INFORMATION These forms must be completed and signed in all appropriate places by the participant, the participant s physician, and if under age 18, by the participant s legal guardian. The medical information we

More information

2015 2016 Classes Begin Monday, August 17 th ** = NEW TIMES & CLASSES

2015 2016 Classes Begin Monday, August 17 th ** = NEW TIMES & CLASSES 2-5 yrs. - PRE - K Monday - 4:15-5:00 T/J - (Pre-K/2-5yrs) Monday - 6:15-7:00 - T/B - (Pre-K/2-5yrs) ** Tuesday - 10:30-11:15 - T/B - (2-5yrs) Wednesday - 10:30 11:15 Ballet/ACRO - (2-5yrs) ** Wednesday-

More information

Texas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment

Texas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment Texas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment Youth s name: Address: Date of birth: Parent/guardian phone: Home Work Pager/Cellular Medical Information

More information

The Lights Fest Austin - Participant Packet overview:

The Lights Fest Austin - Participant Packet overview: Let s Light the sky! In a just a few days (November 19th) - THINGS GET MAGICAL! Whether you ve never done anything quite like this - or if you are a Sky Lantern pro, this info pack contains all the details

More information

Saturday, August 23 rd, 2014 10 am Long Beach Airport 2019 E. Wardlow rd. (Off of Globemaster Way) Long Beach, CA 90807

Saturday, August 23 rd, 2014 10 am Long Beach Airport 2019 E. Wardlow rd. (Off of Globemaster Way) Long Beach, CA 90807 2014 LETR 9 th Annual Plane Pull for Special Olympics Southern California Team Captain Packet Saturday, August 23 rd, 2014 10 am Long Beach Airport 2019 E. Wardlow rd. (Off of Globemaster Way) Long Beach,

More information

Advanced SPIRIT Association

Advanced SPIRIT Association Advanced SPIRIT Association Registration Packet Ladybug Classic April 5, 2014 Whittemore Center Durham, NH REGISTRATION PACKET CHECKLIST STEP 1: Program Information Please complete all contact information

More information

2017 Palm Desert Chill N Grill BBQ Competition

2017 Palm Desert Chill N Grill BBQ Competition 2017 Palm Desert Chill N Grill BBQ Competition Competitor Application March 4, 2017 Check in March 3rd at 9:00am Team Name: KCBS Team# Number of Assistants (Limit 5): Name of Pit Master: Contact Name (If

More information

Camper Information Form

Camper Information Form Camper Information Form NO CAMP HELD ON JULY 4, 2016 Please Mark Dates Attending: Session 1: June 27 July 8 Session 2: July 11 July 22 Session 3: July 25 August 5 ALL 3 SESSIONS Personal Information Name

More information

Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms

Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms All forms and payment are due no later than June 15, 2015 Note: There is a $25 non-refundable registration fee, and no refunds

More information

CHALLENGER WORLD TOURS (CWT)

CHALLENGER WORLD TOURS (CWT) CHALLENGER WORLD TOURS (CWT) TRAVELER REGISTRATION DOCUMENT & TERMS AND CONDITIONS Mail, Fax or Scan/Email To: Challenger World Tours Attn: Gareth Hughes 8263 Flint, Lenexa, KS 66214 USA Phone: 800 878

More information

2015-16 Insurance Information Insurance coverage

2015-16 Insurance Information Insurance coverage 2015-16 Insurance Information Insurance coverage At USA Wrestling, our top priorities are safety and security. That's why we make sure you're covered by General Liability, Accidental Medical Expense, and

More information

NEW STUDENT REGISTRATION

NEW STUDENT REGISTRATION NEW STUDENT REGISTRATION High Performance: Academy Prep: Early Childhood: $20.00 registration fee (includes 2 Academy T-shirts) $20.00 registration fee (includes 2 Academy T-shirts) $10.00 registration

More information

Promotional Offers: Early Bird Discount: 10% discount for participants who are registered by May 17 th and have paid in full.

Promotional Offers: Early Bird Discount: 10% discount for participants who are registered by May 17 th and have paid in full. Dear Parents/Guardians, We welcome all of our returning and new campers to our 2014 Summer Camp Programs. We are excited to embark on another summer of fun and learning. From sports and swimming to arts

More information

San Jose 05.31.14. Party. Check-In. Welcome to The Color Run! Check-in Party. Where: Sports Authority 5170 Steven Creek Blvd, San Jose, CA 95129

San Jose 05.31.14. Party. Check-In. Welcome to The Color Run! Check-in Party. Where: Sports Authority 5170 Steven Creek Blvd, San Jose, CA 95129 San Jose 05.31.14 Welcome to The Color Run! We have developed this race guide to provide you with all the information you will need to make your experience at the event as FANTASTIC as possible. You and

More information

Northstar Travel & Associates

Northstar Travel & Associates Northstar Travel & Associates TRAVEL BOOKING & PASSENGER REQUEST FORM (Please use 1 application form for each participant) NOTE: Please include a photocopy of the first page (ie. photo-page ) of your passport

More information

Karate Adventure Summer Camp

Karate Adventure Summer Camp Karate Adventure Summer Camp Our Summer Karate Camp is one of the most unique summer camps available to children. It provides an enriching selection of self defense activities as well as many fun summer

More information

FUTSAL UNITED STATES YOUTH YOUTH PLAYER REGISTRATION CLUB INFORMATION OFFICIAL USE. Affiliated with LAST NAME FIRST NAME SEX ADDRESS

FUTSAL UNITED STATES YOUTH YOUTH PLAYER REGISTRATION CLUB INFORMATION OFFICIAL USE. Affiliated with LAST NAME FIRST NAME SEX ADDRESS UNITED STATES YOUTH YOUTH PLAYER REGISTRATION FUTSAL Affiliated with League Name State Application date LAST NAME FIRST NAME SEX ADDRESS CITY STATE TELEPHONE ZIP CODE BIRTHDAY / / PLAYER S PHOTO EMAIL

More information

ARCADIA YOUTH RODEO ASSOCIATION, INC. 124 Heard Street, Arcadia, Florida 34266 863-494-2014 2015-2016 SEASON MEMBERSHIP APPLICATION

ARCADIA YOUTH RODEO ASSOCIATION, INC. 124 Heard Street, Arcadia, Florida 34266 863-494-2014 2015-2016 SEASON MEMBERSHIP APPLICATION 2015-2016 SEASON MEMBERSHIP APPLICATION MEMBER INFORMATION: BACK TAG # ISSUED: MEMBER NAME: ADDRESS: CITY: STATE: ZIP: HOME PHONE: CEL #: E-MAIL ADDRESS: (Please send newsletter via: Mail E-Mail ) DATE

More information

CYCLE Kids, Inc. Boston Athletic Association 2017 Official Charity Program Application Packet

CYCLE Kids, Inc. Boston Athletic Association 2017 Official Charity Program Application Packet CYCLE Kids, Inc. Boston Athletic Association 2017 Official Charity Program Application Packet To be considered for selection to the 2017 CYCLE Kids Marathon Team, every interested individual (even those

More information

Dear Corner Stone Charter Parent:

Dear Corner Stone Charter Parent: Dear Corner Stone Charter Parent: Welcome to Boll Family YMCA s School Age Child Care (SACC) program. We are looking forward to sharing the next 11 months with your child before and after school. Attached

More information

Hope s Youth Ministry High School Retreat

Hope s Youth Ministry High School Retreat Hope s Youth Ministry High School Retreat March 6-8, 2015 Pocono Plateau Cresco, PA Hope s Youth Ministry PO BOX 914, 700 Cooper Rd. Voorhees, NJ 08043 Questions or for further information: dave@meethope.org

More information

CAMP MSC SENSATIONAL SUMMER SCIENCE

CAMP MSC SENSATIONAL SUMMER SCIENCE CAMP MSC SENSATIONAL SUMMER SCIENCE Thank you for choosing Camp MSC for your summer camp experience. Our camp programs are designed to be engaging, hands-on, challenging, and of course, fun! All full day

More information

San Antonio Tennis Academy

San Antonio Tennis Academy A Six Sigma Standard- The relentless and rigorous pursuit for near perfection 2014 Summer Tennis Camps at San Antonio Christian School Bronze Summer Camp- (ages 8-14 & intro-intermediate High School) 1

More information

Student Freeride Program

Student Freeride Program 2015/16 Student Freeride Program Registration Packet Student Name: Student Email Address*: School: Grade (6 th -12 th are eligible): Home Phone Number: *Student email may be used to send students updates

More information

SUMMER CAMP GUIDEBOOK

SUMMER CAMP GUIDEBOOK 2017 SUMMER CAMP GUIDEBOOK UNIVERSITY SYSTEM Table of Contents Types of Summer Camps at Lindenwood....3 Housing and Facility Rental Fees. 4 Dining Hall Meal Costs 5 Camp Guidelines..6-7 Proposal Form 1A.

More information

ZSF VOLUNTEERS The Pride of Zoo Miami

ZSF VOLUNTEERS The Pride of Zoo Miami ZSF VOLUNTEERS The Pride of Zoo Miami Dear Parent and Prospective Teen Volunteer: Thank you for your interest in s Teen Volunteer program. The Zoological Society of Florida s Teen Volunteer program is

More information

Race Guide. Orange County. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run!

Race Guide. Orange County. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Be Happy. Be Healthy. Be You. Race Guide Orange County Welcome to The Color Run! Thanks to you and all of your newest friends for making The Color Run one of America s biggest 5k events! We have made this

More information

2012 4-H Camp Workbook

2012 4-H Camp Workbook 2012 4-H Camp Workbook New Flex Registration New Registration Options, New Camper Opportunity! Powered by: CampSylvester.org Online Registration Explore Your Registration and Payment Plan Options. Paper

More information

TEXAS A&M UNIVERSITY-COMMERCE WAIVER PACKET

TEXAS A&M UNIVERSITY-COMMERCE WAIVER PACKET TEXAS A&M UNIVERSITY-COMMERCE WAIVER PACKET 1. TAMU-COMMERCE GENERAL WAIVER All camp participants must complete the TAMU-C General Waiver. 2. CAMPUS RECREATION (MRC & ABE) WAIVER If your camp is utilizing

More information

LATE PAYMENT FEES WITHDRAWAL FROM THE PROGRAM THIRD PARTY (SPLIT) PAYMENTS RESPONSIBLE PARTY. Parent/Guardian Agreement: Dear Parents and Guardians,

LATE PAYMENT FEES WITHDRAWAL FROM THE PROGRAM THIRD PARTY (SPLIT) PAYMENTS RESPONSIBLE PARTY. Parent/Guardian Agreement: Dear Parents and Guardians, Dear Parents and Guardians, In order to simplify and provide better service to everyone, Rancho Simi Recreation and Park District ( the District ) has implemented the following payment processing procedures

More information

Women s Wellness Week

Women s Wellness Week CENTER FOR INTEGRATIVE MEDICINE Women s Wellness Week A week of restorative, healthy living on the Gulf of Mexico November 10 17, 2013 1 Tween Waters Inn, Captiva Island, Florida Renew. Replenish. Rediscover.

More information

B&B Driving School. If you are 15-17, you have come to the right place. At B&B Driving School you are beginning with the best.

B&B Driving School. If you are 15-17, you have come to the right place. At B&B Driving School you are beginning with the best. B&B Driving School Office and Mailing address: 21 E. Hastings Road Spokane, Washington 99218 (509)466-2343 Fax (509)467-6217 PROGRAM NOW INCLUDES DOL WRITTEN AND DRIVE TEST Dear Student: If you are 15-17,

More information

NOTICE OF VOLUNTEER OPPORTUNITY

NOTICE OF VOLUNTEER OPPORTUNITY City of Chicago Rahm Emanuel, Mayor Department of Animal Care & Control NOTICE OF VOLUNTEER OPPORTUNITY NOTICE OF VOLUNTEER OPPORTUNITY Animal Care & Control - UNPAID The Department of Animal Care & Control

More information

Street hockey is a dry land variation of ice hockey that can be played all year-round.

Street hockey is a dry land variation of ice hockey that can be played all year-round. Greetings from the Nashville Predators! We are thrilled to introduce you to an exciting grassroots program from the National Hockey League and Nashville Predators. The NHL has organized a league-wide street

More information

Summer Day Camp Summer 2015. Cooper Y. Summer Adventure Camp Adventure Campers and Extreme Campers

Summer Day Camp Summer 2015. Cooper Y. Summer Adventure Camp Adventure Campers and Extreme Campers Cooper Y Summer Day Camp Summer 2015 Contact Information Kim Pair (402)-323-6408 kpair@ymcalincoln.org Summer Adventure Camp Adventure Campers and Extreme Campers Summer Adventure Camp is a licensed day

More information

SPRING 2016 Youth STEM REGISTRATION PACKET Oakton Community College. Alliance for Lifelong Learning and Center for Promoting STEM

SPRING 2016 Youth STEM REGISTRATION PACKET Oakton Community College. Alliance for Lifelong Learning and Center for Promoting STEM SPRING 2016 Youth STEM REGISTRATION PACKET Oakton Community College Alliance for Lifelong Learning and Center for Promoting STEM 1 Table of Contents OAKTON YOUTH STEM OVERVIEW...3 PROGRAM STRUCTURE...3

More information

2016 Summer Camp Registration Form

2016 Summer Camp Registration Form 2016 Summer Camp Registration Form 1 of 6 2016 Summer Camp Registration Form All forms can be found online: http://go.dtcc.edu/swcamps q New Camper q Returning Camper Office Use Only: Identification Number

More information

WELCOME TO YMCA Teen Scene Middle School Enrichment Program (This sheet is for parents to keep for informational purposes)

WELCOME TO YMCA Teen Scene Middle School Enrichment Program (This sheet is for parents to keep for informational purposes) Robert D. Fowler Family YMCA Middle School Enrichment Program Student Registration Form 2015-16 Ivy Prep Academy Program Hours: 7am-7:45am & 4pm-7pm Transportation AM: Group leaves at 7:30am Transportation

More information

Dear Potential Park Host:

Dear Potential Park Host: Dear Potential Park Host: I am pleased to hear of your interest in the LCRA Park Host program. Enclosed are applications, background check forms, release from liability forms and an information sheet about

More information

The Y: We re for youth development, healthy living and social responsibility.

The Y: We re for youth development, healthy living and social responsibility. Dear Parents/Guardians, We welcome all of our returning and new campers to our 2016 Summer Camp Program. We are excited to embark on another summer of fun and learning with you and your children. From

More information

Child and Youth Group. Volunteer Waiver Form

Child and Youth Group. Volunteer Waiver Form Child and Youth Group Volunteer Waiver Form VOLUNTEER WAIVER WARNING OF RISK, WAIVER, RELEASE OF ALL CLAIMS AGREEMENT Please read this form carefully and be aware that, in participating, you will be waiving

More information

(US citizens under 18 must apply for the ISP guardianship program) Agent? Yes No Agency Name: Agency Contact Person: Street: Country, Zip code :

(US citizens under 18 must apply for the ISP guardianship program) Agent? Yes No Agency Name: Agency Contact Person: Street: Country, Zip code : Last Name (family name) INTERNATIONAL STUDENT PLACEMENTS COLLEGE PROGRAM APPLICATION Attach recent photo here (smiling) Birthdate: Age: Male Female Month / Day / Year (US citizens under 18 must apply for

More information

Winter Camp 2015 Church Registration Instructions and Policies

Winter Camp 2015 Church Registration Instructions and Policies Winter Camp 2015 Church Registration Instructions and Policies Registration Instructions: 1) Choose your weekend(s). Prayerfully consider which available weekend is the best for your church. Bring your

More information

2016 INEX MEMBERSHIP APPLICATION

2016 INEX MEMBERSHIP APPLICATION 2016 INEX MEMBERSHIP APPLICATION ONE FORM PER APPLICANT THE ACCEPTANCE OF THIS APPLICATION AND FEE BY INEX DOES NOT CONSTITUTE MEMBERSHIP APPROVAL. INEX MAY DENY MEMBERSHIP TO ANY APPLICANT FOR ANY REASON.

More information

ROCHESTER AREA BUILDERS, INC Remodelers Tour

ROCHESTER AREA BUILDERS, INC Remodelers Tour ROCHESTER AREA BUILDERS, INC. 2016 Remodelers Tour Entry Check List and Timeline for YOUR Use Check List The following items MUST be submitted to the Association office no later than August 12, 2016, for

More information

Atlanta 04.05.14. Party. Check-In. Welcome to The Color Run! Check-in Party

Atlanta 04.05.14. Party. Check-In. Welcome to The Color Run! Check-in Party Atlanta 04.05.14 Welcome to The Color Run! We have developed this race guide to provide you with all the information you will need to make your experience at the event as FANTASTIC as possible. You and

More information

HOLMDEL SWIM & TENNIS CENTER

HOLMDEL SWIM & TENNIS CENTER HOLMDEL SWIM & TENNIS CENTER For more information call 732-946-2820 ext. 1225 recreation@holmdeltownship-nj.com www.holmdelrec.com LIKE Holmdel Swim Club on Facebook Main Pool (w/2 lap lanes) Intermediate

More information

7 th Annual CHICAGO JAZZ PHILHARMONIC

7 th Annual CHICAGO JAZZ PHILHARMONIC 7 th Annual CHICAGO JAZZ PHILHARMONIC Dear Students and Parents: Welcome to the 7 th Annual CJP Jazz Academy. We have an exciting jazz program lined up for the 2 weeks you will be part of our family. Chicago

More information

CAMP MSC SENSATIONAL SUMMER SCIENCE

CAMP MSC SENSATIONAL SUMMER SCIENCE CAMP MSC SENSATIONAL SUMMER SCIENCE Thank you for choosing Camp MSC for your summer camp experience. Our camp programs are designed to be engaging, hands-on, challenging, and of course, fun! All full day

More information

CONTRACT FOR PRIVATE MUSIC INSTRUCTION

CONTRACT FOR PRIVATE MUSIC INSTRUCTION CONTRACT FOR PRIVATE MUSIC INSTRUCTION I. GENERAL CONDITIONS i. Lessons will be offered over the academic year in each of the instruments for which the student is registered. Students will be scheduled

More information

SCOPE. Winter Explorations Program. Accompsett Middle School. For Smithtown Students. Winter 2017

SCOPE. Winter Explorations Program. Accompsett Middle School. For Smithtown Students. Winter 2017 SCOPE Winter Explorations Program at Accompsett Middle School For Smithtown Students in Kindergarten - 5 th grade COOKING Winter 2017 LEGOS BASKETBALL DRAMA SUPERHEROES CODING ART SCIENCE Saturdays January

More information

Race Guide. Seattle. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Seattle Center Pavillion 305 Thomas St Seattle, WA 98109

Race Guide. Seattle. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Seattle Center Pavillion 305 Thomas St Seattle, WA 98109 Be Happy. Be Healthy. Be You. Race Guide Seattle Welcome to The Color Run! Thanks to you and 7,500 of your newest friends for making The Color Run one of America s biggest 5k events! We have made this

More information

Registration Form Greenpoint Y Arts & Crafts Fall Harvest Fair Greenpoint YMCA Gym Saturday, October 5 10:00 AM 5:00 PM

Registration Form Greenpoint Y Arts & Crafts Fall Harvest Fair Greenpoint YMCA Gym Saturday, October 5 10:00 AM 5:00 PM Registration Form Greenpoint YMCA Gym Saturday, October 5 10:00 AM 5:00 PM Arts & Crafts Fair Vendor Application Form The Greenpoint YMCA is looking to host its first annual Arts & Crafts Fair. Our hope

More information

Please list below any medical conditions and/or allergies the DBA Faculty should be

Please list below any medical conditions and/or allergies the DBA Faculty should be 2015-2016 Registration Form Name Of Child(ren): Date of Birth: Address Where Child Resides: Mailing Address (if different from above): Home Phone Number: Please check next to whom the child resides with:

More information

REGISTRATION FORM. Registration Forms & $200 Deposit due -> October 9, 2016

REGISTRATION FORM. Registration Forms & $200 Deposit due -> October 9, 2016 Northwest University College of Business T H E I M P E R I A L C I T I E S Budapest, Vienna and Prague I N T E R N A T I O N A L B U S I N E S S T O U R M a y 9-1 9, 2 0 1 6 REGISTRATION FORM REGISTRATION

More information