West End’s Summer Camp program is designed for children ages 5 – 12 Enrollment is available for one session or three sessions Session I Session II Session III June 9, 2008 June 30, 2008 July 21, 2008 through through through June 27, 2008 July 18, 2008 August 8, 2008
Monday through Friday 7:30 a.m. to 5:30 p.m. Activities include recreational and instructional swimming, developmentally appropriate educational games, computer lab, cult ural history, arts and crafts, cooking, gym sports, creative writing, tennis, golf and special events and day trips. Session III also includes a Family Fun Day. Breakfast, lunch and snack are served daily. All children must report and be signed into to the Main Building at 710 North Lincoln Street (at the corner of 8 th and Lincoln Streets) before 8:00 a.m. ENTER THROUGH THE YOUTH SERVICE ENTRANCE. CAMP FEE SCHEDULE CATEGORY FAMILY SIZE 2 3 4 5 6 7 8 9 Category 1- $265/session 1 23,880 30,040 36,200 42,360 48,520 54,680 63,840 67,000 Category 2 - $275/session 2 29,859 37,550 45,250 52,950 60,650 68,350 76,050 83,750 3 35,820 45,060 54,300 63,540 72,780 82,020 91,260 100,500 4 41,790 52,570 63,350 74,130 84,910 95,690 106,470 117,250 Category 4 - $350/session
Category 3 - $300/session
Fees for children of the same family (siblings only) are assessed at 90% of the regular fee. Fees for immediate children of West End employees are assessed at 90% of the regular fee. There is a $30.00 NON-REFUNDABLE registration fee PER child, $10.00 of which will be allocated for a year’s Youth Services Membership for that child. Registration fees are waived for State Purchase of Care (POC) participants. A separate application must be completed for EACH child. Camp is funded in part by the United Way of Delaware. Camp Subsidies are also provided by the Wilmington Flower Market.
2008 Summer Camp Application West End Neighborhood House, Inc.
Applicant’s Name Age M or F Date of Birth Staff only Category fee
Address Parent/Guardian
City ___________________ Cell Phone
State Work Phone
Zip Home Phone
1 3
2 4
Emergency Contact Name
Emergency Contact Phone Doctor’s Phone
Family or Primary Care Doctor
Does your child attend a Red Clay School District School? (Yes or No) Will your child attend a Red Clay School District School for the 2008-09 school year. (Yes or No) ENROLLMENT FOR (Check Applicable Session) SESSION I SESSION II SESSION III Full Payment AND all medical forms due by June 6, 2008 Full Payment AND all medical forms due by June 27, 2008 Full Payment AND all medical forms due by July 18, 2008
TERMS OF ENROLLMENT No refunds will be issued for absences or withdrawals during the camp session (NO EXCEPTIONS). Proof of income including a 2007 Tax Return & two recent pay stubs MUST BE SUBMITTED AT TIME OF REGISTRATION. A current physical NO MORE THAN ONE-YEAR-OLD MUST BE SUBMITTED – FORM ATTACHED. All physical forms must be completed & signed by a physician & submitted at the time first full payment is due for each camp session – YOUR CHILD WILL NOT BE ABLE TO ATTEND WITHOUT A PHYSICAL FORM AND PHYSICIAN’S SIGNATURE. Full payment must be submitted by dates listed above for EACH session. No partial payments are accepted for any session (NO EXCEPTIONS).
My child has my permission to participate in West End Neighborhood House, Inc.’s Summer Camp and any field trips off the prem ises. West End Neighborhood House, Inc., United Way and its agents are held harmless for any injury arising from participation in the programs of said agencies and the actions of the agents of said agencies. I also hereby give my permission for West End Neighborhood House, their assigns, licenses and legal representatives the irrevocable right to use and reuse copyrights of my child’s/children’s photograph in all forms, media and advertising, trade or other purposes. I waive any rights to inspect or approve the finished product, including a copy that may be created in connection therewith. Signature of Parent and/or Guardian Date