Camp Registration Form

CAMP REGISTRATION FORM
CHILD INFORMATION:

A separate form must be completed for each child attending.
Name*

First NameLast Name
Name of School*
Birth Date*

MonthDayYear
Age*
T-shirt info (shirt provided for summer camp only)*
MEDICAL INFORMATION
Physician

First NameLast Name
Phone Number

Area CodePhone Number
Medical Concerns
PARENT/GUARDIAN INFORMATION:
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityCountry

Postal / Zip CodeCountry
Home Number

Area CodePhone Number
Work Number

Area CodePhone Number
Cell Number*

Area CodePhone Number
Do you use Whatsapp?*
Messages and ads will be sent via Whatsapp. Please add 869-663-2353
E-mail*
Name of person (s) to pick up child*
CAMP AND/OR PRE-CAMP ATTENDANCE
Regular Camp session attending*

EasterSummerChristmas
Child will attend regular camp for.. (Please insert SPECIFIC ATTENDANCE DATE in 'other' if the child will not attend camp for the entire period)*

1 week2 weeks3 weeks4 weeks5 weeksOther
Pre-Camp session attending (one week unless otherwise advertised)*

EasterSummerChristmaswill not attend
CAMP FEES

Attendance fee includes snacks, lunch and field trips. Camp fee is payable before the start of camp and on Fridays for every week thereafter. There will be no field trips during Pre-Camp.
Non-refundable Registration Fee -payable upon submission of form/ by stipulated deadline.*

$75.00 - Easter camp only$100.00 - Summer camp only$75.00 - Christmas camp only$50.00 - Pre-Camp only$100 - Pre & Easter Camp$100 - Pre & Christmas Camp$125 -Pre and Summer Camp
Attendance Fee*

$50.00 daily$175.00 weekly
PAYMENT METHOD

Cheques are to be made payable to Jacqueline P. Flemming. Mobile banking details will be forwarded upon receipt of registration form.
Payment Type*

ChequeCashNB Mobile Banking
Parent/Guardian Signature*
For registration questions and additional information contact

Jacqueline Flemming – SKN PREMIER CAMP PLANNERS

P O Box 1431, Basseterre, St Kitts

Tel: (869) 663-2353 Email: sknplan@gmail.com
Enter the message as it's shown*
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CAMP REGISTRATION FORM

CHILD INFORMATION:

MEDICAL INFORMATION

PARENT/GUARDIAN INFORMATION:

CAMP AND/OR PRE-CAMP ATTENDANCE

CAMP FEES

PAYMENT METHOD