SUMMER CAMP REGISTRATION FORM

(one form per child)

Child’s Name Parent’s Name

Preschool

(3-5 year olds) Page 1 of 2

Please select the camps you wish to enroll your child in.

Parents!

See page 2 for Payment

Information & Parent Signature!

More programming on page 2!

Safari Camp (Preschool / 3-5-year-old) Monday/Wednesday/Friday Location: Friendship Station Preschool $46 (N/R $69) per week CAMP Hours (9-11:30am, M/W/F) Week 1: June 8-12 | Code 3211201-1A Week 2: June 15-19| Code 3211201-2A Week 3: June 22-26 | Code 3211201-3A Week 4: NO CAMP Week 5: July 6-10 | Code 3211201-5A Week 6: July 13-17 | Code 3211201-6A Week 7: July 20-24 | Code 3211201-7A Week 8: July 27-31 | Code 3211201-8A Week 9: Aug 3-7 | Code 3211201-9A

Safari Camp (Preschool / 3-5-year-old) Tuesday/Thursday Location: Friendship Station Preschool $32 (N/R $48) per week CAMP Hours (9-11:30am, T/TH) Week 1: June 8-12 | Code 3211201-1B Week 2: June 15-19| Code 3211201-2B Week 3: June 22-26 | Code 3211201-3B Week 4: NO CAMP Week 5: July 6-10| Code 3211201-5B Week 6: July 13-17 | Code 3211201-6B Week 7: July 20-24 | Code 3211201-7B Week 8: July 27-31 | Code 3211201-8B Week 9: Aug 3-7 | Code 3211201-9B

Unique Camps (see below for age specifications):

3-5 year olds June 8-11, M-Th | 9-11am | Storybook Adventures | Ages 3-5 | Friendship Station Preschool |$49 (N/R $74) | Code 3211210-01 June 15-18, M-Th | 9-11am | Short Sports Camp | Ages 3-5 | Friendship Station Preschool |$49 (N/R $74) | Code 3211211-01 June 22-25, M-Th | 9-11am | Everyday Heroes | Ages 3-5 | Friendship Station Preschool |$49 (N/R $74) | Code 3211215-01 July 6-10, M-F | 9-11am | My Little Princess Camp | Ages 3-5 | Friendship Station Preschool |$63 (N/R $93) | Code 3211212-01 July 13-16, M-Th | 9-11am | Messy Business Camp | Ages 3-5 | Friendship Station Preschool |$49 (N/R $74) | Code 3211213-01 July 20-23, M-Th | 9-11am | Lil’ Crafty Camp | Ages 3-5 | Friendship Station Preschool |$49 (N/R $74) | Code 3211214-01

5-7 year olds June 8-11, M-F | 12-3pm | Cool Construction Camp | Ages 5-7 | SPRC |$72 (N/R $102) | Code 3211222-01 June 15-19, M-F | 9:30am-1:30pm | “Nothing But Sports” Camp | Ages 5-7 | SPRC |$87 (N/R $117) | Code 3211221-01 NEW! June 22-26, M-F | 9-11am | Test Track Camp | Ages 5-7 | SPRC |$49 (N/R $74) | Code 3211223-01 July 6-10, M-F | 9:30am-1:30pm | Pretty Princess Camp | Ages 5-7 | SPRC |$93 (N/R $123) | Code 3211220-01 NEW! July 13-16, M-Th | 1-3pm | Super Hero Training | Ages 5-7 | SPRC |$49 (N/R $74) | Code 3211224-01

Fun-2-Play! Camp – Ages 5-12 August 10-14, M-F (Between the last day of summer camp and the start of school) Camp Hours 8:30am-3:30pm | $122 (N/R $152) | Code 3211260-1A Extended Hours AM 6:30-8:30am | $20 (N/R $30) | Code 3211260-1B Extended Hours PM 3:30-6pm | $25 (N/R $38) | Code 3211260-1C

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Please note:

you may sign up for

M/W/F and/or T/TH.

Special activities will

not be repeated.

Preschool—Ages 3-5 Camp Hours: 9am-noon Location: SCC Fee: $90 (N/R $110) per week

Week 1: June 8-12,M-F | Code 3112136-01 Week 2: June 15-19, M-F | Code 3112136-02 Week 3: June 22-26, M-F | Code 3112136-03 Week 4: June 29-July 3, M-F | Code 3112136-04 NO CAMP July 6-10 Week 5: July 13-17, M-F | Code 3112136-05 Week 6: July 20-24, M-F | Code 3112136-06 Week 7: July 27-31, M-F | Code 3112136-07 Week 8: Aug 3-7, M-F | Code 3112136-08

Kindergarten—1st grade Camp Hours: 9am-noon Location: SCC Fee: $90 (N/R $110) per week

Week 1: June 8-12,M-F | Code 3212157-01 Week 2: June 15-19, M-F | Code 3212157-02 Week 3: June 22-26, M-F | Code 3212157-03 Week 4: June 29-July 3, M-F | Code 3212157-04 NO CAMP July 6-10 Week 5: July 13-17, M-F | Code 3212157-05 Week 6: July 20-24, M-F | Code 3212157-06 Week 7: July 27-31, M-F | Code 3212157-07 Week 8: Aug 3-7, M-F | Code 3212157-08

Peck Farm Park Camps (see below for age/grade specifications):

Payment Authorization Credit/Debit: MasterCard Visa Discover Am-Ex Card #

Print Name as it appears on card Expiration Date: CVV:

CASH CHECK

Signature of Parent/Guardian Date

Signature of Credit/Debit Cardholder: Date

For Office Use ONLY: Prepared by: ___________Date: ___________Amount: ___________Pmt Method: ___________

Copy for Special Needs Request given to:

Kelly (Traditional / Unique Camps) Ryan (Gymnastics Camps) Kim (PFP Camps)

Notes:

NEW! FULL-DAY Camp Coyote

(Grades K-2)

Monday—Friday

Location: PECK

Hours: 9am-4pm

Fee: $180 (N/R $210)per week

June 1-5 |Slippery Animals/Insects on the Prairie| Code 3212808-01

June 8-12 |Dinosaurs Lifecycle/Surrounded by Water| Code 3212808-02

June 15-19 |Slimy Experiments/Jurassic Dinosaurs| Code 3212808-03

June 22-26 |Fun with Water/Slime Up Close| Code 3212808-04

June 29-July 3 |Parade of Beetles/Carnivores Rule| Code 3212808-05

July 6-10 |Soaked in Science/Beautiful Butterflies| Code 3212808-06

July 13-17 |Insect Defenses/Gross Slime| Code 3212808-07

July 20-24 |Dinosaurs Unleashed/Science Explored| Code 3212808-08

July 27-31 |Flying Insects/Ocean Dinosaurs| Code 3212808-09

Aug. 3-7 |Serious Slime/Insect or Arachnoid?| Code 3212808-10

Aug. 10-14 |Big & Little Dinos/Experiments in Density| Code 3212808-11

Camp Coyote for Little Explorers

(Ages 4-5)

Monday—Friday

Location: PECK

Hours: 9am-12pm

Fee: $95 (N/R $115)per week

June 1-5 | Code 3112801-01 June 8-12 | Code 3112801-02 June 15-19 | Code 3112801-03 June 22-26 | Code 3112801-04 NO CAMP the week of June 29-July 3 July 6-10 | Code 3112801-05 July 13-17 | Code 3112801-06 July 20-24 | Code 3112801-07 July 27-31 | Code 3112801-08 Aug. 3-7 | Code 3112801-09 Aug. 10-14 | Code 3112801-10

HALF-DAY Camp Coyote for children entering grades K-2

June 1-5, Mon-Fri | 9am-12pm | Slippery, Slimy Science | Grades K-2| PECK| $95 ($115) | Code 3212801-03

June 1-5, Mon-Fri | 1pm-4pm | Incredible Insects | Grades K-2 | PECK | $95 ($115) | Code 3212801-01

June 8-12, Mon-Fri | 9am-12pm | Dinosaurs Unleashed! | Grades K-2 | PECK| $95 ($115) | Code 3212801-07

June 8-12, Mon-Fri | 1pm-4pm | Soaked In Science | Grades K-2 | PECK| $95 ($115) | Code 3212801-31

June 15-19, Mon-Fri | 9am-12pm | Slippery, Slimy Science | Grades K-2 | PECK | $95 ($115) | Code 3212801-04

June 15-19, Mon-Fri | 1pm-4pm | Dinosaurs Unleashed! | Grades K-2 | PECK | $95 ($115) | Code 3212801-08

June 22-26, Mon-Fri | 9am-12pm | Soaked In Science | Grades K-2 | PECK | $95 ($115) | Code 3212801-32

June 22-26, Mon-Fri | 1pm-4pm | Slippery, Slimy Science | Grades K-2 | PECK | $95 ($115) | Code 3212801-05

June 29-July 3, Mon-Fri | 9am-12pm | Incredible Insects | Grades K-2 | PECK | $95 ($115) | Code 3212801-02

June 29-July 3, Mon-Fri | 1-4pm | Dinosaurs Unleashed! | Grades K-2 | PECK| $95 ($115) | Code 3212801-09

July 6-10, Mon-Fri | 9am-12pm | Soaked In Science | Grades K-2 | PECK | $95 ($115) | Code 3212801-33

July 13-17, Mon-Fri | 9am-12pm | Incredible Insects | Grades K-2 | PECK| $95 ($115) | Code 3212801-21

July 13-17, Mon-Fri | 1pm-4pm | Slippery, Slimy Science | Grades K-2 | PECK| $95 ($115) | Code 3212801-06

July 20-24, Mon-Fri | 9am-12pm | Dinosaurs Unleashed! | Grades K-2 | PECK | $95 ($115) | Code 3212801-22

July 20-24, Mon-Fri | 1pm-4pm | Soaked In Science | Grades K-2 | PECK| $95 ($115) | Code 3212801-34

July 27-31, Mon-Fri | 9am-12pm | Incredible Insects | Grades K-2 | PECK| $95 ($115) | Code 3212801-26

July 27-31, Mon-Fri | 1pm-4pm | Dinosaurs Unleashed! | Grades K-2 | PECK | $95 ($115) | Code 3212801-29

August 3-7, Mon-Fri | 9am-12pm | Slippery, Slimy Science | Grades K-2 | PECK| $95 ($115) | Code 3212801-28

August 3-7, Mon-Fri | 1pm-4pm | Incredible Insects | Grades K-2 | PECK| $95 ($115) | Code 3212801-27

August 10-14, Mon-Fri | 9am-12pm | Dinosaurs Unleashed! | Grades K-2 | PECK| $95 ($115) | Code 3212801-30

August 10-14, Mon-Fri | 1pm-4pm | Soaked In Science | Grades K-2 | PECK| $95 ($115) | Code 3212801-35