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2008 Summer Art Camp
Registration Form Information

 
  mail to Cheltenham Center for the Arts , 439 Ashbourne Rd., Cheltenham, PA 19012
  telephone 215-379-4660
  fax 215-663-1946
 
Please use a separate registration form for each camper.
 
Date _____________________    Male [ ]  Female [ ]       
 

Student Name________________________________________  Nickname_____________________________
  Age ________________________________  Child's Birth Date ___/___/___ 
  Are You a New Camper?   Yes [ ]  No [ ]   Past Year's at CAC Camp _______________
  School Attending _______________________________________  Last Grade Completed _________________
  Parent/Guardian Names ______________________________________________________________________
  Child's Address _____________________________________________________________________________
  City____________________________________________ State________________ Zip___________________
  Home Phone (Mother) _______/________________  Work Phone (Mother)______/_________________________
  Home Phone (Father) _______/________________  Work Phone (Father)_______/_________________________
  Email _____________________________________________________________________________________
  Emergency Contact ________________________________________  Phone _______/____________________
  Allergies/Special Concerns ____________________________________________________________________
  Swimming Level:  Kiddie Pool [ ]  Low End [ ]  Deep End [ ]
  T-shirt:  Child [ ]  Adult [ ]         Size:  Small [ ]  Medium [ ]  Large [ ]  X-Large [ ]
  Where did you hear of our camp? _________________________________________________________________
   
  Summer Art Camp Dates        
  Please Check Camp Option(s):        
  Crafty Kids Week (1 Week) : June 16-20
No Pool Trip this Session		   Non-Member Rate
Member Rate
 
    [ ] Full Day (9am - 3:30pm)
[ ] Morning Session (9am - 12pm)
[ ] Afternoon Session (12:30-3:30pm)
[ ] Extended Care (3:30pm-5:30pm) 		 

$220
$115
$115
$65
$215
$110
$110
$60
  
       
 
  Session 1 (2 weeks) : June 23-July 3
No Pool Trip this Session - Closed July 4th 		   
 
    [ ] Full Day (9am - 3:30pm)
[ ] Morning Session (9am - 12pm)
[ ] Afternoon Session (12:30-3:30pm)
[ ] Extended Care (3:30pm-5:30pm) 		  $400
$200
$200
$105
$380
$190
$190
$95
  
         
 
  Session 2 (2 weeks) : July 7- July 18    
 
    [ ] Full Day (9am - 3:30pm)
[ ] Morning Session (9am - 12pm)
[ ] Afternoon Session (12:30-3:30pm)
[ ] Extended Care (3:30pm-5:30pm) 		  $440
$225
$225
$115
$420
$215
$215
$105
  
         
 
  Session 3 (2 weeks) : July 21- August 1    
 
    [ ] Full Day (9am - 3:30pm)
[ ] Morning Session (9am - 12pm)
[ ] Afternoon Session (12:30-3:30pm)
[ ] Extended Care (3:30pm-5:30pm) 		  $440
$225
$225
$115
$420
$215
$215
$105
  
             
  Session 4 (2 weeks): August 4 -August 15    
 
    [ ] Full Day (9am - 3:30pm)
[ ] Morning Session (9am - 12pm)
[ ] Afternoon Session (12:30-3:30pm)
[ ] Extended Care (3:30pm-5:30pm) 		  $440
$225
$225
$115
$420
$215
$215
$105
  
             
    Crafty Kids Week (1 Week) : August 18- August 22
No Pool Trip this Session		    
     ] Full Day (9am - 3:30pm)
[ ] Morning Session (9am - 12pm)
[ ] Afternoon Session (12:30-3:30pm)
[ ] Extended Care (3:30pm-5:30pm) 		  $220
$115
$115
$65
$215
$110
$110
$60
  
   

Tuition Subtotal:
Less Discounts:
Subtotal:
Less Enclosed Deposit:
Balance Due by June 16, 2008.:

  

_______________
_______________
_______________
_______________
_______________

    
         
Payment Conditions      
 

A $100 Non-Refundable Deposit is required to secure all registrations.
+The deposit will be credited towards the total amount due.
+ Members receive a discount on tuition.
+ Register for two or more sessions and receive a $25. discount on total tuition
+ Registration Deadline and All Balances Due by June 16, 2008
+ Any balance paid after June 16 will be charged a late fee of $15 total tuition.
+ No camper may attend unless full fees are paid in full.
+ Fees incurred to CCA by returned checks (NSF) are the responsibility of the parent.

  
   
         
Cheltenham Center for the Arts staff, faculty and counselors do not disburse or handle prescription or over the counter medication and are not trained to care for special needs children. If you have any concerns please contact the Director of Education.
Payment Method      
  [_] Cash___[_]Money Order___ [_] Check Enclosed____[_] Visa____[_]MC
       
  Card No. __ __ __ __ ---__ __ __ __---__ __ __ __---__ __ __ __
  Expiration Date________ __ / __ __  
       
  I hereby give permission for my child to take part in all camp programs, including off-premises trips, and to be photographed during camp activities. Additionally, I give permission for my child to be treated by a local doctor, or area hospital in the case of a medical emergency. In making this application, I subscribe for the duration of the applicant’s enrollment at the camp to the terms and regulations of the camp as set forth in its publications and notices and assume full liability for all indebtedness incurred on account of fees by the applicant.
Signature of
Parent /Guardian		 ________________________________________________ DATE: ___________________

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