PISCATAWAY TOWNSHIP SCHOOLS by 39Y4e4

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									                     **Register by March 30 for Discounted Rate**                                          Lunch is included in
                          2012 Summer Camp Program                                                             the price!
                 Wednesday, June 27 through Friday, August 24, 2012                                         Monday through
                                                                                                               Thursday
                                 2012 Registration Form
Camper’s Last Name                       Camper’s First Name                      Present Grade(2011-2012 school year)



Home Address                                              City                           State


Present School                                                   Campers Date of Birth


Any Restraining Orders       Yes      No      If Yes, a copy is required

Provide any personal information (allergies, behavioral medication, etc.) we need to know that will help
with your child’s adjustment to camp:_______________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________


CONTACT INFORMATION IN CASE OF AN EMERGENCY
                     Mother/Guardian               Father/Guardian                         Alternate Contact

Name
Address
Home
Phone
Work
Phone
Cell Phone
Email
Address


                          T-Shirt Size:
                          Youth  XS (4-5)  S (6-8)  M (10-12)  L (14-16)
                          Adult  S  M  L  XL
                          Additional Shirts can be purchased at the Summer Camp Meeting.




                     **Register by March 30 for Discounted Rate**

IMPORTANT INFORMATION
*Program fee for 2012 is $1,950.00; register before March 30 the fee is $1,750.00.
*Program will be held at Piscataway High School from 7:00am to 6:30pm.
*$100.00 non-refundable deposit is due at the time of registration. Final payment is due by May 24, 2012.
*There are no make up days for absences or days missed.



                                               - Over -
           CAMP PERMISSION SLIPS
           Registration for 2012 camp constitutes permission for the Piscataway Summer Camp to take my child on
           local trips outside camp as part of the regular camp program.

           PICTURES
           Unless you inform us otherwise, camp registration includes permission for photographs to be taken.
           Piscataway Schools may utilize photographs in camp brochures, display photography or electronic media.
           If you do not want your child’s picture taken please check here 

           EMERGENCY AND MEDICAL CARE
           In the event that you cannot be contacted in an emergency you hereby grant permission for Piscataway
           Summer Camp to bring your child to the emergency room. I also hereby give permission to the medical
           personnel selected by the camp director to provide routine healthcare.

           ACTIVITIES
           My child has permission to engage in all programmed camp activities, except as noted on the camper’s
           medical form. Piscataway Summer Camp is based on a 5 day per week, 8 ½ -week experience.

           TUITION REFUND POLICY & REDUCTION OF WEEKS
           No tuition will be refunded. There are no refunds for absences or withdrawals from camp. No allowance or
           credit will be issued for missed, cancelled or changed weeks. I understand that if I have not paid my child’s
           balance in full by the May 24, 2012, my child's enrollment is subject to cancellation.

           DISMISSAL OF CAMPER
           The camp reserves the right to dismiss any camper whose condition, conduct, influence, or behavior is
           deemed unsatisfactory or detrimental to the best interest of the camp, the camper or their fellow campers.

           PARENT SIGNATURE
           I hereby enroll my child with a deposit and this application for the number of weeks stated herein. I
           will adhere to the tuition payment policy and understand the camp refund policy

           ____________________________________________                ___________________________________
           Parent Signature                                            Date

                                               Tuition for 2012 - $1,950.00
                       **Register by March 30 for Discounted Rate of $1,750.00**


           TUITION:        DEPOSIT $100.00                    PAID IN FULL $__________________________

                                        CHECK#________              VISA____      MC____

           ACCOUNT#___________________________________________________EXP DATE______________
                              RETURN TO: Piscataway Community Education,
                                  1515 Stelton Road, Piscataway, NJ 08854
             2nd Child                       (732) 572-4688                 Office use only
           (please check)             First Come, First Served               Date Received:

Lunch is included in the                                                                           _________________
         price!
   Monday through
       Thursday
 Lunch is included in the            PISCATAWAY TOWNSHIP SCHOOLS
          price!                         2012 Summer Camp Program
Monday through Thursday
                                              Toddler to Eighth Grade

        The Piscataway 2012 Summer Camp Program provides children with an active, fun-filled
        learning environment that combines morning enrichment classes, afternoon recreation
        including swimming, day trips, and indoor and outdoor experiences. Certified teachers,
        teaching assistants, and trained counselors supervise the program.

                                                           Program Location
                            The toddler (18 month) to eighth grade camp program will be held at
                            Piscataway High School, Doors #29 and #30 in the East Wing.

                                                              Program Dates
                            The program will operate from Wednesday, June 27, through Friday, August 24,
                            for a total of 8 1/2weeks.


                                                          Hours of Operation
                            The program will operate from 7:00 a.m. until 6:30 p.m. It will be the responsibility of
                            the parent or guardian to pick-up their child by 6:30 p.m. A late fee of $10.00 per 15
                            minutes will be charged at pick up time for campers picked up after 6:30 p.m.


                                            ***Food - We are providing lunch!***
                                                         Monday through Thursday
                            Students will receive a nutritious lunch Monday through Thursday with a choice of
                            hot or cold food ranging from sandwiches, to spaghetti or pizza. Students are only
                            responsible for providing their own lunch on Fridays. Parents should still pack
                            water and snacks daily.

                                                                   Clothing
                            Students should wear comfortable clothes and bring a gym bag with swimsuit and towel
                            on swim days. Each student will be given a camp shirt to be worn on field trips.


                                                                 Field Trips
                            Field trips are conducted frequently and parents are given advance notice of trips. There
                            are no additional costs for the trips. Some field trips being considered for this summer
                            are: Funtown Pier Seaside, Dorney Park, Kids Village, and Waterparks just to name a
                            few. Not all grade levels go on the same trips. Trips are planned in accordance to the
                            child’s age level.

                                                                      Fees
                            The all-inclusive fee for the Piscataway Summer Camp 8 ½ -week program is $1,950.00.
                            If you register before March 30 the discounted fee is $1,750.00. This includes field trips.
                            An additional fee is charged if children are picked up after 6:30 p.m. from the program.

                                                                Registration
                            The registration fee is $100.00 per child due at time of registration. This non-refundable
                            fee is deductible from the total cost and must accompany the application form. It is
                            recommended that registration be in person at the Administration Building from 8:00
                            a.m. to 4:00 p.m. You may pay the tuition in installments, but tuition must be paid in full
                            by May 24, 2012. Returned checks from the bank will be charged a $30.00 service fee.

								
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