Camp Eagle Summer Camp Registration Form 2022

REGISTRATION

1. One time registration fee required per child. (includes 2 shirts & a backpack, pre-selected below)

2. Choose at least one week.

3. Choose your payment option.

A. Full Payment (includes $5 discount)

B. Non-Refundable deposit only.

(Remaining balance is due on Monday of each camp week.)

C. Include early/after care (optional).

4. If purchasing additional shirts, enter number of additional shirts needed.
Camp Eagle Registration

Fields marked with an * are required fields and must be completed before submitting the form.
Camper 1 Name *

First Name Last Name Nickname
Camper 1 DOB *

Month Day Year
Camper 1 Height (Inches) *
Camper 1 Grade Entering for School Year 2022-2023 *
Camper 1 Sex *
Camper 1 T-Shirt Size *
Campers are required to wear Camp Eagle shirts each day they attend camp. 2 shirts are provided. Additional shirts may be purchased at $10 each.
Do you have an additional sibling to add?

Yes No

Camper 2 Name *

First Name Last Name Nickname
Camper 2 DOB *

Month Day Year
Camper 2 Height (Inches) *
Camper 2 Grade Entering for School Year 2022-2023 *
Camper 2 Sex *
Camper 2 T-Shirt Size *
Campers are required to wear Camp Eagle shirts each day they attend camp. 2 shirts are provided. Additional shirts may be purchased at $10 each.

Primary Contact:
Name *

First Name Last Name Relationship
E-mail *
Cell Phone: *
Work Phone:
*Optional
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Secondary Contact:
Name

First Name Last Name Relationship
Cell Phone:
Work Phone:
E-mail
Emergency Contacts:

*Other than the above. Please specify relationships.
Emergency Contact #1
Name *
First Name, Last Name
Phone *
*Best number to call.
Relationship *
Emergency Contact #2
Name
First Name, Last Name
Phone
*Best number to call.
Relationship
Authorized to Pick Up

*Other than Primary or Emergency contacts.

*Authorized person will be required to show driver's license at pick up.
Name

First Name Last Name Best Number to Call
Name

First Name Last Name Best Number to Call
Person(s) Not-Authorized for Pick Up
In completing this application for Camp Eagle, I, {name}, understand and agree that: 1. Applications will not be processed without registration payment. 2. Camp administration has full responsibility in placing my child in the proper age group for any and all activities. 3. My child(ren) may go on all scheduled camp activities and field trips. 4. I do hereby grant permission for my child(ren) listed above, to participate in the 2022 Camp Eagle summer care program at The Master's Academy. I further acknowledge and understand that there is a possibility that my child may sustain physical injury or illness (minimal, serious, or catastrophic) in connection with his/her participation. I further acknowledge and understand that my child is assuming the risk of such physical injury or illness by his/her participation. I further release The Master's Academy and its representatives (including employees, directors, and coaches) from any claims for personal injury or illness that my child may sustain during participation in this camp. I further understand that The Master's Academy has established rules and regulations pertaining to conduct, behavior, activities, and health/hygiene of all students by which my child must abide during participation in this program and that my child and I will be responsible for his/her failure to abide by those rules and regulations.
Signature
- There is a $5/week discount for paying in full now.

- Sibling discounts are $12/week.

- Extended Care can also be purchased each week your child(ren) attends at a cost of $30 per family.

-To purchase additional weeks after the initial registration please use the code "ADDWK" when checking out to remove the $100 registration fee.

Weekly Registrations:

Registration $ 100.00

Registration Fee includes 2 t-shirts and a drawstring backpack.

# of Campers
Item subtotal: $ 0.00

July 5-8 (No Camp Mon., July 4) $ 200.00

Extravangaza Week #3

Payment Type
Item subtotal: $ 0.00

July 11-15 $ 200.00

Payment Type
Item subtotal: $ 0.00

July 18-22 $ 200.00

Payment Type
Item subtotal: $ 0.00

July 25-29 - Last Week of Camp! $ 250.00

Extravaganza Week #4

Payment Type
Item subtotal: $ 0.00

Additional Shirts $ 10.00

For Camper:	Quantity
Camper 1
Camper 2

Enter coupon

Total $ 0.00

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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