CAMP ELINGS 2017 REGISTRATION | JUNE 12 – AUGUST 18, 2017
CAMPER INFORMATION
Camper’s Name, Last:
First:
Date of Birth:
Gender: Male
Female
Phone:
(circle one)
Current Address:
City:
Age:
State:
Weight:
Shirt size: S M L XL
ZIP Code:
Email:
Mother/guardian name, Last:
First:
Phone:
Father/guardian name, Last:
First:
Phone:
EMERGENCY CONTACT
Emergency contact name (other than parent):
Phone:
Allergies or medical conditions:
PLEASE CIRCLE THE CAMP(S) YOU WOULD LIKE TO SIGN UP
Week 1
June 12-16
Week 2
June 19-23
Week 3
June 26–30
Week 4
July 3-7
Week 5
July 10-14
Week 6
July 17-21
Week 7
July 24- 28
Week 8
Jul 31 -Aug 4
Week 9
August 7-11
Week 10
August 14-18
Sports &
Nature
Ages 5 - 12
$230
Sports &
Nature
Ages 5 - 12
$230
Sports &
Nature
Ages 5 - 12
$230
Sports &
Nature
Ages 5 - 12
$195
Sports &
Nature
Ages 5 - 12
$230
Sports &
Nature
Ages 5 - 12
$230
Sports &
Nature
Ages 5 - 12
$230
Sports &
Nature
Ages 5 - 12
$230
Sports &
Nature
Ages 5 - 12
$230
Sports &
Nature
Ages 5 - 12
$230
BMX
$250USA
Ages 5 – 12
BMX
$250 USA
Ages 5 - 12
BMX
$250 USA
Ages 5 - 12
BMX
$200USA
Ages 5 - 12
BMX
$250 USA
Ages 5 - 12
BMX
$250 USA
Ages 5 - 12
BMX
$250 USA
Ages 5 - 12
BMX
$250 USA
Ages 5 - 12
BMX
$250 USA
Ages 5 - 12
BMX
$250 USA
Ages 5 - 12
BMX
Membership
Required
BMX
Membership
Required
BMX
Membership
Required
BMX
Membership
Required
BMX
Membership
Required
BMX
Membership
Required
BMX
Membership
Required
BMX
Membership
Required
BMX
Membership
Required
BMX
Membership
Required
Tennis
Ages 5 – 12
$225 half
$400 full
Tennis
Ages 5 – 12
$225 half
$400 full
Tennis
Ages 5 – 12
$225 half
$400 full
Tennis
Ages 5 – 12
$225 half
$400 full
Tennis
Ages 5 – 12
$180 half
$320 full
Tennis
Ages 5 – 12
$225 half
$400 full
Tennis
Ages 5 – 12
$225 half
$400 full
Tennis
Ages 5 – 12
$225 half
$400 full
Tennis
Ages 5 – 12
$225 half
$400 full
Tennis
Ages 5 – 12
$225 half
$400 full
Lacrosse
Ages 5 – 12
$170
Lacrosse
Ages 5 – 12
$170
Lacrosse
Ages 5 – 12
$170
Lacrosse
Ages 5 – 12
$140
Friendship
Camp
Ages 4-22
$355
Friendship
Camp
Ages 4-22
$355
Friendship
Camp
Ages 4-22
$355
Friendship
Camp
Ages 4-22
$355
Friendship
Camp
Ages 4-22
$355
Friendship
Camp
Ages 4-22
$355
Camp hours: Full day 9 am to 3 pm. Half day: 9 am to 12 pm
OPTIONAL EXTENDED CARE
Monday
Tuesday
Wednesday
Thursday
Friday
8 am – 9 am / $5
8 am – 9 am / $5
8 am – 9 am / $5
8 am – 9 am / $5
8 am – 9 am / $5
3 pm – 6 pm / $15
3 pm – 6 pm / $15
3 pm – 6 pm / $15
3 pm – 6 pm / $15
3 pm – 6 pm / $15
CAMP ELINGS 2017 REGISTRATION | JUNE 12 – AUGUST 18, 2017
AUTHORIZED PICK-UP (in addition to parents)
Name:
Phone:
Relationship:
Name:
Phone:
Relationship:
Name:
Phone:
Relationship:
PAYMENT IFORMATION
Payment method: CASH
VISA
MASTER CARD
CHECK#:
Card holder name:
Card #:
Exp. Date:
Billing zip code:
CCV#:
IMPORTANT REGISTRATION INFORMATION
CANCELLATION POLICY:
We are always happy to help you move to another session so your child will not miss out on their fun summer camp experience. If you do need to
completely cancel your child’s participation, we ask that you let us know as soon as possible. Refund amounts depend on the amount of notice you are
able to give us.



If you cancel more than 7 days before camp session starts: Entire camp fee is refunded, less a $25 administrative fee.
If you cancel 7 or fewer days before camp session starts: A $25 camp processing fee will be charged and half (50%) of camp fee is refunded.
If you cancel after camp has started, no refund will be provided.
MEDICAL REASON FOR CANCELLATION
If your child has a medical emergency or becomes ill, please let us know as soon as you can. We will ask for a written medical excuse note from your
child’s physician, but will work to help you place your child in a later camp session if at all possible. If your child is unable to participate in a future camp
session, a $25 camp processing fee will be charged and you will be refunded the remaining balance.
“I have read and understand all terms and policies listed above. I hereby authorize the Elings Park Camp Staff to act for my child to the best of their
judgment in any emergency requiring medical attention. I hereby waive and release Elings Park Foundation and Elings Park Camp Staff from any and all
liability for injuries or illness incurred while at camp. I have no knowledge of any physical impairment that would affect the named camper's
participation in any of the camp programs. I agree to direct my child to cooperate and to follow directions and instructions of any Elings Park Staff. I
understand that if my child fails to follow instructions from Elings Park Staff, I may be called to pick her/him up. I also give Elings Park permission to
use my child's photograph for any future education and/or public relation purposes.”
Parent / legal guardian signature: ______________________________________________
Date:____________________
1298 Las Positas Road, Santa Barbara, CA 93105 | Phone: 805-569-5611 | Fax: 805-569-3316 | www.elingspark.org | [email protected]
1298 Las Positas Road, Santa Barbara, CA 93105 | 805-569-5611 |
www.elingspark.org