Summer Camp
2008 Registration Form

Use this form to register on-line for Camp Simpresca. You will establish your initial priority for space at camp.

We can send final confirmation of your booking only after we have received:

a cheque for a non-refundable deposit of $100 for each session a camper is to be registered ( part of the total camp fee), and
your post-dated cheque for the balance of the total camp fees, dated June 30, 2008.
we also accept payment by VISA. If you are interested in paying your child's Camp Registration fee by VISA, please contact the Camp Registrar.

By submitting this on-line Camp Registration form, you acknowledge that you have read, and are agreeing to, the Conditions of Enrollment located at the bottom of this application.

Mail your cheque's to:

The Camp Simpresca Registrar
Sharon MacKenzie
5563 County Road 10
North Essa
Alliston ON L9R 1V2
Canada

Make your cheques payable to CAMP SIMPRESCA.

A separate form and deposit is required for each child and camp period.

Registrations received after June 1^st must be accompanied with full payment.

If you have any questions, send an e-mail to the Camp Registrar. You may also telephone the Registrar at 705-434-4635, or send a fax to 705-434-4682.

Week-Long Camps (ages 8-16)

	camp #5	Sunday August 10 to Saturday August 16	$395.00 - Teen Camp
	camp #6	Sunday August 17 to Saturday August 23	$395.00

Mini Camps (ages 6-10)

		Wednesday July 2 to Saturday July 5	$195.00
		Wednesday July 30 to Saturday August 2	$195.00

Leaders Program
(See web site for details)

Counselor-in-Training Program:
(completed grade 10 or 16 years old)

Wednesday July 6 to Saturday August 23

$780.00

Leadership-In-Training Program:

(completed grade 9 or 15 years old)

	Camp #1	Sunday July 6 to Saturday July 26	$680.00
	Camp #2	Sunday August 3 to Saturday August 23	$680.00

Camper Information

E-mail Address:
Camper's First Name:
Camper's Last Name:
Street Mailing Address:
City:
Province/State:
Postal Code:
Country:
Camper's Birth Date:
Sex:

Camp Information

Camp:
I would like to be in a cabin with (one choice):
Number of years I have been at Camp Simpresca:
Church Affiliation:
Does your child have any medical or behavioural problems or require medication? Does you child require the support of a one-on-one worker at home or school? If yes, please specify:

Contact Information

Parent/Guardian's name:
Telephone Numbers (applicable):	Daytime - Home Mother - Work Father - Work Phone - Other (please explain i.e. cell, etc)
Other Comments/Explanations (brief)

Conditions of Enrollment

The Camp Simpresca Board of Directors/Registrar reserves the right to refuse registration or attendance if it is decided that the child cannot be provided with a safe and enjoyable camping experience.

The Camp Director reserves the right to dismiss a camper who, in his/her opinion, has displayed unacceptable behaviour and/or has not complied with the rules of the camp. Camp fees are non-refundable if a child is sent home for misbehaviour.

The parent or guardian submitting this application must have legal custody over the child. Conditions of custody and access, if applicable, should be fully indicated in writing to the camp.

I hereby give permission and the legal right to Camp Simpresca for the use and ownership of any written or audio-visual material and photographs of the above-named camper for publicity and promotional purposes.

Cabin placement of campers is at the discretion of the Director.

If my child is found to have head lice or nits, I agree to voluntarily remove my child from camp until such time as my child is free of lice and nits.

I have read all of this application form and the Camp Simpresca brochure and I understand and accept the conditions of enrollment.

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Summer Camp 2008 Registration Form

Conditions of Enrollment

Summer Camp
2008 Registration Form