UMBC

 

2014 UMBC Summer Day Camp Registration

Contact Information

Email address *

 

Registration Number

How many children are you registering? ($50 per child) *

 

Information for Child (1)

Full Name
Gender
  Female
  Male
Grade Entering in 2014-15 School Year
Date of Birth (MM/DD/YYYY)

 

Information for Child (2)

Please fill out the below section if you are registering more than one child

Full Name
Gender
  Female
  Male
Grade Entering in 2014-15 School Year
Date of Birth (MM/DD/YYYY)

 

Information for Child (3)

Please fill out the below section if you are registering more than two children

Full Name
Gender
  Female
  Male
Grade Entering in 2014-15 School Year
Date of Birth (MM/DD/YYYY)

 

Information for Child (4)

Please fill out the below section if you are registering more than three children

Full Name
Gender
  Female
  Male
Date of Birth (MM/DD/YYYY)
Grade Entering in 2014-15 School Year

 

Session Options

Camp Tuition:

Registration Fee: $50 (one-time charge for each child that must be payed upon submission of this form)

Regular Day: $225 (week 3 $185)

Extended Day: $260 (week 3 $200)

Discount: $15 per week (UMBC employee, or all siblings)

Sessions Attending: Regular Day (If your child is not attending any regular day sessions be sure you check "None") *
(click all that apply)
  None
  Week 1 (June 16-20)
  Week 2 (June 23-27)
  Week 3 (June 30-July 3) *camp closed Friday, July 4
  Week 4 (July 7-11)
  Week 5 (July 14-18)
  Week 6 (July 21-25)
  Week 7 (July 28-August 1)
  Week 8 (August 4-8)
  Week 9 (August 11-15)
Sessions Attending: Extended Day (If your child is not attending any extended day sessions be sure you check "None") *
(click all that apply)
  None
  Week 1 (June 16-20)
  Week 2 (June 23-27)
  Week 3 (June 30-July 3) *camp closed Friday, July 4
  Week 4 (July 7-11)
  Week 5 (July 14-18)
  Week 6 (July 21-25)
  Week 7 (July 28-August 1)
  Week 8 (August 4-8)
  Week 9 (August 11-15)
Please specifiy if have two or more children that will NOT be attending the same weeks. Please provide the name of each child and what weeks they will be attending

 

Parents/Guardians Information

Name *
Daytime Phone # *
Home Phone #
Address *
City *
State *
Zip *
E-mail *
Name
Daytime Phone #

In case of emergency, additional person(s) to notify:

Name
Daytime Phone #
Name
Daytime Phone #
Are there any medical problems that would prevent the child's participation in day camp activities?
  Yes
  No
If Yes, please state
In consideration of the acceptance of my child/children as a UMBC day camper, I hereby agree to comply with the terms stated in the UMBC summer day camp brochure. *
  I agree to the following terms.

 

Payment Options

How would you like to pay for your selected weeks? Please remember payment for a selected week is due one month prior to the start of that week *
  Full Payment for all selected weeks
  Pay in monthly installments
Once you submit this form you will receive a confirmation email. Within that email you will find a link to our payment options page. Please use this to submit full payment for all selected weeks or to select which weeks you would like to pay for. *
  I have read the above notice on payment options
 
* = required field

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