2010 Camp Program Registration Form

Please indicate only one session (Please submit separate forms for another child or additional weeks)

Print this form and either mail in with a cheque to address below or Fax with Credit Card
(call in card number if preferred)
Alternatively click the Online Store button on the previous menu for Online Secure Credit Card Registration.

Please make cheque payable to East Park Golf Gardens:
Mail to: 1275 Hamilton Rd. London, ON N5W 1B1 Tel: 519-451-2950 Fax: 519-451-5047
If you have any problems or questions you can Email: info@eastparkgolf.com

As of May 1st 2010 all prices are subject to HST
 
First Name : Sex: Male Female
Last Name: Address:
Age: City:
Birthday: Postal Code:
   
Golf - Level 1
Golf - Level 2
Rock Climbing - Level 1
Junior Fun Camp
(M) Morning Only $125
(FD) Full Day $190

Full Day $210
(M) Morning Only $125
(FD) Full Day $190

Full Day $190
MFD (1) July 5 - 9
(10) July 12 - 16
MFD (14) July 5 - 9
(23) July 5 - 9
MFD (2) July 12 - 16
(11) July 19 - 23
MFD (15) July 12 - 16
(24) July 12 - 16
MFD (3) July 19 - 23
(12) Aug 9 - 13
MFD (16) July 19 - 23
(25) July 19 - 23
MFD (4) July 26 - 30
(13) Aug 16 - 20
MFD (17) July 26 - 30
(26) July 26 - 30
MFD (5) Aug 2 - 6   MFD (18) Aug 2 - 6 (27) Aug 2 - 6
MFD (6) Aug 9 - 13   MFD (19) Aug 9 - 13 (28) Aug 9 - 13
MFD (7) Aug 16 - 20   MFD (20) Aug 16 - 20 (29) Aug 16 - 20
MFD (8) Aug 23 - 27   MFD (21) Aug 23 - 27 (30) Aug 23 - 27
MFD (9) Aug 30 - Sept 3   MFD (22) Aug 30 - Sept 3 (31) Aug 30 - Sept 3
       
Need Clubs: Right Left Have Own
Early Drop off / Late Pickup: Early drop $20/week Both Early and Late $30/week
Late Pickup $20/week No Early Drop off or Late Pickup
Lunch: Lunch Program $30/week No Lunch Program

Item Name Payment with HST
 
 
 
 
 
 
SUBTOTAL
 
HST
 
Full Payment Upon Registation  
FULL PAYMENT
 
For Deposit of $100 and Payment with Post Dated Cheque for June 15 upon Registration  
LESS DEPOSIT -$100.00
BALANCE DUE
 
Groups 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 Name: Date:
Parent Home Phone #: Parent Work Phone #:
E- Mail Address: Other Phone#:
Emergency Contact Name: Emergency
Phone:
E- Mail Address: Other Phone#:
Doctor's Name: Doctor's Phone #:
Health Card #:    
 
(Optional)
Allergies and Medical Conditions:
Other Note:

PAYMENT POLICY:
A DEPOSIT OF $100 IS REQUIRED FOR EACH SESSION REGISTERED FOR AT THE TIME OF REGISTRATION IN ORDER TO HOLD A SPOT IN ANY SESSION. BALANCE OF PAYMENT IS DUE BY JUNE 15, 2010 (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.



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