mad science strike camps 2014 (2)

Week: September 2-5, 9:00 - 3:00 Working Scientist's Exploration Camp for children K-Gr.6 duration: 4 full days cost: $170.00 (1h Pre and 1h Post care available @ $50.00/week) Week:September 8-12, 9:00 - 3:00 3,2,1... Blast off for children K-Gr. 6a duration: 5 full days cost: $205.00 (1h Pre and 1h Post care available @ $50.00/week) For day to day basic registration ($42 per day) contact Mad Science office directly DON`T WORRY, if strike won't continue, we will return unused portion of the camp fee. LOCATION: ............................................................... Dates: ...........................................Camp Name: .................................................... Child: .......................................................................................................Grade: ............. Date of Birth: ................................................... First Name Last Name Parent: ................................................................................................................................................................................................................... First Name Last Name e-mail Phone # Emergency Contact: ....................................................................................................................................................................................... First Name Last Name phone number/cell Relationship Home Address: ............................................................................................................................................................................................... Paid by: Cash Cheque Credit Card:.....................................................☜Name on the Card: AMOUNT: ......................................................................................................................................................................................................................................................................... Visa-Mastercard ☐☐☐☐ ☐☐☐☐ ☐☐☐☐ ☐☐☐☐ Expiry: ☐☐/☐☐ My child has the permission to participate in the Mad Science Summer Camp. ______________________________________ I understand Mad Science classes may be photographed or videographed for research, training, or promotional purposes. signature Students must be picked up at the Mad science classroom. Sign out will be required. Alergies/Health concerns: ............................................................................................. if none please indicate “none” ............Strike Camp STRIKE CAMPS A difficult situation is brewing chaos and uncertainty. We may have a solution for you - Mad Science's imaginative and unique programs and SUMMER CAMPS perfect for children K - G6 x Mad Science Vancouver Island 250-391-1814 or 1-888-954-6237 FAX: 250-483-5816 www.madscience.org/vancouverisland Register online! or mail/fax filled in registration and payment to Mad Science. 3436 Karger Terrace, Victoria, BC, V9C 3K5 Make cheques payable to Mad Science Vancouver Island. DEADLINE: August 29, by 2:00 PM

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Page 1: Mad science strike camps 2014 (2)

Week: September 2-5, 9:00 - 3:00

Working Scientist's Exploration Camp for children K-Gr.6duration: 4 full dayscost: $170.00 (1h Pre and 1h Post care available @ $50.00/week)

Week:September 8-12, 9:00 - 3:00

3,2,1... Blast off for children K-Gr. 6aduration: 5 full dayscost: $205.00 (1h Pre and 1h Post care available @ $50.00/week)

For day to day basic registration ($42 per day) contact Mad Science office directly

DON`T WORRY, if strike won't continue, we will return unused portion of the camp fee.

LOCATION: ............................................................... Dates: ...........................................Camp Name: .................................................... !

Child: .......................................................................................................! Grade: .............! Date of Birth: ...................................................!! First Name! Last Name !

Parent: ...................................................................................................................................................................................................................!!! First Name ! Last Name! ! e-mail ! Phone #

Emergency Contact: .......................................................................................................................................................................................!! First Name ! Last Name! phone number/cell! Relationship

Home Address: ...............................................................................................................................................................................................!

Paid by: Cash Cheque Credit Card:.....................................................☜Name on the Card: AMOUNT: .........................................................................................................................................................................................................................................................................!

Visa-Mastercard ☐☐☐☐ ☐☐☐☐ ☐☐☐☐ ☐☐☐☐ Expiry: ☐☐/☐☐My child has the permission to participate in the Mad Science Summer Camp. ______________________________________!I understand Mad Science classes may be photographed or videographed for research, training, or promotional purposes. signature

Students must be picked up at the Mad science classroom. Sign out will be required.

Alergies/Health concerns: .............................................................................................if none please indicate “none”! ............Strike Camp

STRIKE CAMPSA difficult situation is brewing chaos and uncertainty. We may have a solution for you - Mad Science's imaginative

and unique programs and SUMMER CAMPS

perfect for children K - G6

Mad Science Vancouver Island 250-391-1814 or 1-888-954-6237

FAX: 250-483-5816www.madscience.org/vancouverisland

3436 Karger Terrace, Victoria, BC, V9C 3K5Make cheques payable to Mad Science Vancouver Island.

DEADLINE: August 29,by 2:00 PM

http://www.madscience.org/vancouverisland

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