Saint john XXIII Summer Camp 2016

                                                                                

Saint John XXIII PRIDE Summer Camp 2016 Join Saint John XXIII Catholic School for a “faith-filled” summer experience nurturing the “WHOLE” child. 2016 Pride Summer Camp is accepting students entering K - 5th grades for the 2016-2017 school year. Curriculum includes academics, technology, foreign language, arts/crafts, physical education, Bible adventure, field trips and more!    Weekly sessions from 6/6/16 thru 8/5/16.  Instructors are AZ Certified Teachers.                                                                For more information:                                                               480-905-0939/website at www.saintjohnxxiii.org Summer Camp Registration Form Student Information (please print)                            Parent/Guardian Information (please print) First Name: __________________________          M: ___   F: ____ □  Father  □  Mother  □  Legal Guardian Last Name: _________________________ Name: _________________________ Address: ___________________________    Tee shirt size: XS  S  M  L  XL Work Phone: __________________________ City: ____________________ State: _____ Zip: ______ Cell Phone: ___________________________ Grade (16-17) school year): ____      School: ________________ Email: _________________________________ Home Phone:__________________________ Part 1: Complete for week(s) your student WILL be attending SJXXIII Pride Summer Camp. For The Week Beginning June July August Costs 6th 13th 20th 27th *** 5th 11th 20th 25th 1st # of weeks Fee per week* Total Camp (9 am – 2 pm) x $240   $                         Ext Day (8-9 am 2-4 pm) x $ 60   $ ***NO CAMP on 7/4 $192   $ Ext. Day week of 7/5 $48   $ Registration fee (non-refundable)   $ 30 EXTRA camp t-shirts ONLY Size:  XS  S  M  L  XL Qty   x $10 Total  Summer Camp fees   $ * The camp fee includes Friday Pizza Party, Field Trip transportation and admission costs.  The registration fee includes ONE camp Tee shirt to be worn every day. If you would like additional tee shirts (at a cost of $10/shirt), please indicate the number and sizes above. Part 2:  Total Fees Due for Summer Camp Total Summer Camp Fees (from Part 1) $ Deposit (registration fee plus the first week’s payment required to reserve spot) $ Remaining balance $ Payment Information ** □ FACTS Account (for SJXXXIII Students) Signature ___________________________________________________________ (By signing this form, I authorize SJXXIII to charge my FACTS account for the deposit five days after remittance of this form and the remaining weekly fees on the Friday before the start of that camp week) □ Other payment method (for those without a FACTS account) Cash  $ ____ Check (payable to Saint John XXIII Catholic School) ____ Check #: _____ Amount: _____ Credit Card -       Visa ______ MasterCard ______ Amex ______ Discover ______ Credit Card Number ____________________________________ Expiration Date ____________________ Security Code ____________________ (last 3 digits on back for Visa and MasterCard, on front for Amex) Signature __________________________________________________________________________ (By signing this form, I authorize SJXXIII to charge my card – when received for the deposit and the remaining weekly fees on the Friday before the start of that camp week.) ** Registration fees are non-refundable.  Weekly camp fees can be applied to another week with one week’s notice.  A two week notice is required for refund of the weekly camp fees.