Honey Creek Summer Camp Registration Form 2009

 Mail in registration forms must be received by June 1, 2009

 

Print a form (pdf format)

Print a form (rtf format)

 

For all sessions, send $75 non-refundable deposit with this  form to:

Camp Registrar, 379 Greens View Rd, Sewanee, TN 37375 or email in your application to ginajenk@aol.com

Make check payable to:  Summer Camp Program.  Balance of $275 is due upon arrival.

You will receive a letter of confirmation which will have additional information about your camp session.  Check session that you are registering for:

___ High School – Sunday June 14-Saturday, June 20 (completed grades 9-12)

___ St. Gregory – Sunday June 21-Saturday June 27 (completed grades 3-6)

___ St. Peter – Sunday July 5 – Saturday July 11 (completed grades 6-8)

___ St. Joseph and Mary – Sunday July 12-Saturday July 18 (completed grades 3-5)

___ St. Francis – Sunday July 19-Saturday July 25 (completed grades 7-9)

 

** T-Shirt Size  Circle One:    Child    S     M     L    or Adult   S    M     L     XL    **

 

Name ________________________________________ Nickname ________________________

Church ______________________________ Age _____ Birth date ______________ Sex ______

Grade 08-09 Year _______

Street Address _________________________________________________________________

City ____________________________________________ State ________ Zip _____________

Parent/Guardian ________________________________ Home Phone _____ - ______ - _______

Work Phone _____ - ______ -________   Cell Phone  _____- _______ - _________

In case of need, I authorize required medical care for my child by the camp nurse, physician, or by any hospital rendering service.  I also authorize any hospital or physician to release any medical or financial information to the camp representative if the need arises.  The hospital or physician is released from all legal responsibility or liability that may arise from the release of this medical information.

Parent Signature ______________________________________________ Date _________________________

____ I give permission for my child to be photographed for the promotion of future Diocesan youth events.

____ I do not give permission for my child to be photographed for the promotion of future Diocesan youth events.

 

 

Parent Signature ______________________________________________ Date ____________________________

Text Box: Early Registration Special If we receive your registration form and $75.00 deposit by May 1, 2009 you will receive a $25.00 discount for the cost of the remaining balance of summer camp.