103rd Scientific Assembly
and Annual Meeting
November 26 to December 1
McCormick Place, Chicago
Camp RSNA Registration
Deadline: November 17, 2017
Camp RSNA childcare in the McCormick Place Convention Center is open to
children ages 6 months – 12 years. Full day, half day and hourly rates are available.
Full day: 8:00 am –6:30 pm
Half day: 8:00 am –1:00 pm or 1:00 pm –6:30 pm
Deadline for advance registration is November 17, 2017. After November 17,
registration is subject to availability. Onsite registrants will be charged an extra $10
for full-day and half-­day service. For further information regarding Camp RSNA,
please call ACCENT on Children’s Arrangements, Inc. at 1-504-524-0188.
Rates: A non-refundable registration fee of $10.00 per child is required.
Infants and Toddlers (6–35 months)
Full day: $85.00
Half day: $50.00
Hourly: $15.00
Children (3–12 years)
Full day: $65.00
Half day: $40.00
Hourly: $12.00
Child’s Name
Age
Gender
Birthdate
Child’s Name
Age
Gender
Birthdate
Child’s Name
Age
Gender
Birthdate
THE CHILD(REN) NAMED ABOVE WILL BE RELEASED ONLY TO THE PERSON(S) SIGNING THIS APPLICATION.
X
Father/Guardian Full Name
Signature
X
Mother/Guardian Full Name
Signature
Address
Daytime Telephone
Cell Number
City
State/Province
Email Address
ZIP/Postal Code
Payment: (make checks payable to ACCENT on Children’s Arrangements, Inc.)
Check enclosed MasterCard Visa
Card Number
Expiration
Name as it appears on card
X
Authorized Signature Required
Parents Open House Sunday, November 26, 8:00 am –8:30 am
DATE
Drop-Off Pick-Up
Time
Time
Meals are not included in the registration. Those planning to enroll children in Camp RSNA
during meal times may order meals on this registration form. We will assume your child
will attend during the hours registered. If your schedule changes, we need as much notice
as possible. You will receive a refund for cancellation received in writing to ACCENT
offices by November 17, 2017. You will receive no refund for cancellation made after that
time. Any registration made after November 17, 2017, will receive no refunds. “No Shows”
receive no refund. This policy is to ensure proper staffing, which is in the best interest of
your child. ACCENT reserves the right to substitute programs of same/greater value or
cancel programs based on enrollment.
Half Day $50 (<3yrs)/$40 (>3yrs) Hourly Rate Per Child Full Day $85 (<3yrs)/$65 (>3yrs) $15 (<3yrs)/$12 (>3yrs)
Number of
Children
Registration Fee Lunches
$10 per Child
@ $15 each
TOTAL
SUNDAY, NOVEMBER 26
8:00 am –6:30 pm
MONDAY, NOVEMBER 27
8:00 am –6:30 pm
TUESDAY, NOVEMBER 28
8:00 am –6:30 pm
WEDNESDAY, NOVEMBER 29
8:00 am –6:30 pm
THURSDAY, NOVEMBER 30
8:00 am –6:30 pm
November 17, 2017, is the deadline for Camp RSNA Registration.
After this date, registration is subject to availability.
Mail completed form to: RSNA/ACCENT Convention Camp
615 Baronne St., Suite 303 New Orleans, LA 70113
Telephone: 1-504-524-0188
Fax: 1-504-524-1229
E-mail: [email protected] or register online at: www.accentregister.com/register/RSNA17
MTG851 RB