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CAMP NORTHLAKE
For Children entering Kindergarten thru
Sixth grade
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70104 Wolverine
Drive - Covington, LA 70433
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June 2nd-July 25,
2008
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8:00 –3:00
YOU MAY APPLY
ONLINE HERE, OR DOWNLOAD A PAPER APPLICATION
BY
CLICKING HERE. Please note that your application will not be
considered complete until we receive your registration fee and camp
tuition. Please mail checks to Camp Northlake, 70104 Wolverine
Drive, Covington, LA 70433. |
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Child's Name
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Home Phone
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Home Address
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City/State/Zip
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Grade Entering
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School
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Age
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Sex
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List any allergies, disabilities or other special needs your child may have.
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REQUIRED: Email (This will be our primary means of communication for announcements, newsletters, etc.)
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FAMILY INFORMATION: |
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Mother's Name
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Mother's Employment
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Mother's work Phone
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Mother's Cell Phone
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Father's Name:
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Father's employment:
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Father's work phone:
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Father's cell phone:
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Student Lives with
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both parents
father
mother
other
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If 'Other,' please answer:
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If parents are separated or divorced, who has legal custody of the child?
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Emergency Contact:
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Relationship to child:
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Emergency Contact Phone:
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Emergency Contact cell phone:
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CAMP SCHEDULE & FEES Camp runs from 8:00am – 3:00pm
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$ 50.00 Registration fee per child –
no discounts (non-refundable) |
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$150.00 per week , includes lunch |
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$175 per week includes lunch and
after care until 5:30pm |
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Before care: 7:00-8:00am - $1.00
due daily when child arrives (If paid in advance, no refunds are
given for un-used days) |
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Please check the 2 week minimum plus any additional weeks. Weeks do not have to be consecutive.
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Week 1 June 2-6
Week 2 June 9-13
Week 3 June 16-20
Week 4 June 23-27
Week 5 June 30-July 3 (Closed July 4th)
Week 6 July 7-11
Week 7 July 14-18
Week 8 - July 21-24 |
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REQUIRED FEES;
Please submit your registration fee plus 2 weeks tuition
with this application to the CAMP NORTHLAKE office. Applications
will be processed when all fees are received. Fees for
additional weeks are due and payable in advance on Monday of each
week. Please put your child’s name on each check/payment.
T-SHIRTS
Your child will be required to wear a camp T-shirt each
day. Two shirts are included with the registration fee. For each
additional shirt, the cost is $8.00. |
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Please indicate number of ADDITIONAL shirts desired (2 are included with registration fee.)
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Please indicate size t-shirt.
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XS (2-4)
S (6-8)
M (10-12)
L (14-16)
XL (18-20)
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Parent’s Agreement:
I hereby give authority to Northlake Christian School (Camp
Northlake):
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To care for my child during the time he or she is in the
facility.
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To secure emergency medical care for my child in case of the
inability of the Camp to reach me.
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Child's Doctor
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Doctor Phone:
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By typing your name in the box, you understand and agree that you are responsible to pay for the week(s) that your child is registered whether he/she attends all week or not. NO REFUNDS AFTER MAY 1, 2008.
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To submit this online application, please type
in your Name and email address once again. |
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Name:
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Email Address:
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