2008 Camp Program Registration Form

Please indicate only one session (Please submit separate forms for another child or additional weeks)
Golf - Level I Level 2 Rock Climbing - Level 1 Junior Fun Camp
(1)  q   June 30 - July 4 (10) q    June 30 - July 4 (13)  q   June 30 - July 4 (22)  q   June 30 - July 4
(2)  q   July 7 - 11 (11)  q July 21 - 25 (14)  q   July 7 - 11 (23)  q   July 7 - 11
(3)  q July 14 - 18 (12)  q Aug 11 - 15 (15)  q July 14 - 18 (24)  q July 14 - 18
(4)  q July 21 - 25   (16)  q July 21 - 25 (25)  q July 21 - 25
(5)  q July 28 - Aug 1   (17)  q July 28 - Aug 1 (26)  q July 28 - Aug 1
(6)  q Aug 4 - 8   (18)  q Aug 4 - 8 (27)  q Aug 4 - 8
(7)  q Aug 11 - 15   (19)  q Aug 11 - 15 (28)  q Aug 11 - 15
(8)  q Aug 18 - 22   (20)  q Aug 18 - 22 (29)  q Aug 18 - 22
(9)  q Aug 25 - 29   (21)  q Aug 25 - 29 (30)  q Aug 25 - 29
NAME:_________________________________________________ SEX:____________
AGE:________  ADDRESS:__________________________________________________  CITY: ____________
POSTAL CODE_____________       q MORNING ONLY       q FULL DAY
Need Clubs: 
q Right   q Left  
q Have Own 
Early drop or Late Pickup $ 20/week q
Both Early and Late $30/week q
Lunch Program $30/ week q
     
Classes limited in size and East Park reserves the right to reschedule sessions based on registration.
Release Form: 
My child has permission to participate in the East Park Golf Gardens Limited Camp Program, and I give permission to East Park personnel to render medical aid to my child should it be of a necessity.
PARENT SIGNATURE______________________   PARENT NAME: ______________________ 
DATE:___________________________________   PARENT PHONE #: ______________________ 
EMERGENCY CONTACT NAME:____________________  EMERGENCY PHONE #:____________________ 
PARENT'S WORK#:________________________
DOCTOR'S NAME:_________________________             DOCTOR'S PHONE #:______________________
HEALTH CARD #:__________________________
ALLERGIES AND MEDICAL CONDITIONS_____________________________________________________
OTHER NOTES: __________________________________________________________________________
PAYMENT POLICY: 
A DEPOSIT OF $100 IS REQUIRED AT THE TIME OF REGISTRATION IN ORDER TO HOLD A SPOT IN ANY SESSION.  BALANCE OF PAYMENT IS DUE BY JUNE 15, 2008 (please include post dated cheque).
CANCELLATION POLICY: 
A FULL REFUND WILL BE PROVIDED IF CANCELLATION IS AT LEAST TWO (2) WEEKS PRIOR TO THE REGISTERED SESSION, SUBJECT TO A $15 ADMIN CHARGE.  IF CANCELLATION IS LESS THAN TWO (2) WEEKS PRIOR TO THE REGISTERED SESSION THEN THE DEPOSIT WILL BE FORFEITED. 
OFFICE USE ONLY:
DEPOSIT ($100) $________ DATE:_______________
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Balance - $ __________________
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    Please make cheque payable to East Park Golf Gardens:
    Level I Camps - Morning only $130; Full Day $200 /  Level II Camp - Full Day $220 / Jr. Fun Camp Full Day $195
    Mail to:  1275 Hamilton Rd.  London, ON  N5W 1B1  Tel: 519-451-2950 Fax: 519-451-5047 Email: info@eastparkgolf.com