Three-Flavors Kids' Club
Tel: (416)900-1578 . (416)829-6306 .
Email: [email protected]
www.threeflavors.org
Summer Camp Registration Form - 2017
Summer Camp
Child
Computer Camp
Name
International Camp
Address
Date of Birth
Gender
Chess Camp
(YYYY/MM/DD)
Male
Female
Postal Code
City
Home Phone
Mother
Father
Name
Name
Cell Phone
Cell Phone
Work Phone
Work Phone
Email
( Note: All camp broadcast information, personal confirmation and tax
receipt will be sent to the registered email address. )
Child Alert Information
Allergies/Medications
Action for Allergies/Medications
Camp Location
Adrienne Clarkson PS
Silver Stream PS
Camp Weeks Requested
July 4 - 7
July 10 - 14
Jul 31 - Aug 3
Moraine Hills PS
Roméo Dallaire PS
Extended Time Requested
July 17 - 21
July 24 - 28
7:30-8:00AM
8:00-9:00AM
Aug 8 - 11
Aug 14 - 18
4:00-5:00PM
5:00-6:00PM
Memo
Consent and Declaration
The undersigned parent or legal guardian hereby agrees:
1.
If my child is accepted as a camper, I hereby waive and forever discharge Three-Flavors Kids' Club, its directors, officers, employees and
volunteers from all claims, damages, costs and expenses in respect to injury or damage to his/her person or property, however caused, which
may occur as a result of his/her participation in the camp program in any location where the program is being held.
2.
In the event of an accident or illness occurring to my child and both parents could not be reached, I grant permission for the treatment of my
child by a physician available nearby the program location.
3.
Three-Flavors Kids' Club reserves the right to decide unilaterally to dismiss any camper whose conduct is deemed as negative influence to
other campers. Any such disciplinary decision will be made in accordance with our camp procedure.
4.
I acknowledge and agree that Three-Flavors Kids' Club (1) may use my child's photographs which are taken during activities and events for
club promotional use, (2) send the emails about camp information, club program information and tax receipt to the above email address.
Parent/Guardian Signature:
Date:
Three-Flavors Kids' Club
Tel: (416)900-1578 . (416)829-6306 .
Email: [email protected]
www.threeflavors.org
Summer Camp Registration Form
PAYMENT INFORMATION
1.
Summer Camp Fee:
Full Day
$ 145 / week (5 Days)
$ 125 / week (4 Days)
Computer Camp Fee:
Full Day
$ 220 / week (bring own computer)
$ 280 / week (use camp's computer)
Chess Camp Fee:
Full Day
$ 190 / week (5 Days)
$ 160 / week (4 Days)
Before/After Camp
$ 3 / hour (max $10 / day)
2.
Additional $15 of material fee is required for the first payment.
3.
Deposit cheque $50 is required if the discount is applied.
4.
Payment can be made in cheques only.
5.
Please make cheques payable to “Three-Flavors Kids' Club”, and print your child name in memo.
Post-dated cheque dated on May 1st is required for the weeks registered.
SUBMIT FORM & PAYMENT
6.
Please complete one form for each camper.
7.
In Person:
Please submit your registration form and payment in the following time. Please enclose the registration form and payment in an envelope
with your child name on it.
Address: Silver Stream Public School
180 Farmstead Road, Richmond Hill, ON L4S 2K9 (Major MacKenzie & Shirley)
Time:
8.
Fridays 6:15PM to 8:45PM (Please check our schedules online)
Online:
Registration online is available on our website www.threeflavors.org.
CANCELLATION & REFUND POLICY
10. Before June 15th: Cancellation requires is subject to $50 administration fee.
After June 15th: (1) Cancellation requires 4 weeks notice and is subject to $50 administration fee per week.
(2) There are no refunds once the camp week has started.
(3) There will be no discounts for the days not attended.
CONFIRMATION
11. Confirmation will be sent to your email address within one week once your registration information and/or payment are received.
TAX RECEIPT
12. Tax receipt will be issued and sent to your email address provided in this form at the year end.
Questions? Please email or call us for any questions about registration or payment.