GSSEF Summer Camp Registration Form 2014
Complete one registration form per girl. Registration forms received without a completed, legible form and payment/deposit will not be processed. This form may be copied. Print very clearly.
Girl Name:
Age:
Grade Entering for Fall 2014:
Adult Contact (this adult will receive all confirmation materials): Contact Address: City:
State:
Zip:
Contact Adult Email: Day Phone:
Other Phone:
Unit Buddy:
RESIDENT CAMP OR WEEKEND CAMP: Give us the name of one girl, of the same grade level, who should be placed in the same unit. Requests will be accommodated based on availability in each unit at the time of the registration.
I (as named above) am the adult contact for this child and by checking this box, I agree that I have read and understand the GSSEF Camp General Information which includes but is not limited to the following: grade-level requirements, required health forms, cancellation procedure and refund policy. Campfires: More Than S’mores: $6 x (# of people) Fairy Tale Campfire: $5 x (# of people) S’mores & More: $5 x (# of people)
Resident Camp:* Camp H2Ohhh!!: $450 Trail Mix: $450 Weekend Camp: Renaissance Weekend: $50 Grossology: $35 Midnight Mayhem: $35 Art-Rageous: $35 Color Wars: $50 Iron Chef Weekend: $60 Frozen: $35 The Hunger Games: $60 One-Day Camp: Dude, That’s My Dad!: $20 x (# of people) Thanksgiving In June: $20 x (# of people) Badge Daze: $20 x (# of people) Me & My Mom: $20 x (# of people)
Day Camp: Session 1: $125 Northern Broward County transportation: $50 Central Palm Beach County transportation: $50 Session 2: $125 Northern Broward County transportation: $50 Central Palm Beach County transportation: $50 Session 3: $125 Northern Broward County transportation: $50 Central Palm Beach County transportation: $50 *A $100 non-refundable deposit is required for registration by May 23, 2014 for each session, per girl.
T-Shirt (select one for Resident, Weekend AND Day Campers) Youth Size: X-Small Small Medium Large or Adult Size: Small Medium Large XL Sub-Total: Discount: (minus) Total Due: Total Enclosed/Authorized:
$ $ $ $
Sibling Discount Financial Assistance
Credit Card: American Express Discover Master Card Visa or Check # Name as it Appears on Card: Credit Card Number: Exp. Date: Billing Address: (If different from contact information above)
Checks payable to GSSEF
Security Code:
Mail this form to: GSSEF . Attn: Summer Camp . 4701 NW 33rd Avenue . Oakland Park, FL 33309 Fax (with credit card payments only): 954-735-2402 . Se habla Español: 954-513-3786