Summer Camp Ends August 4th - registration for last week of camp is CLOSED
This Form cannot be submitted until the missing
fields (labelled below in red) have been filled in
2017 APV Summer Camp Registration Form
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-Mail Address*
Street Address*
City*
State/Prov*
Zip/Postal Code*
Home Phone*
Student's Name*
Age *
---Select---
5
6
7
8
9
10
11
12
School
Please list ADA Accommodations needed
Single Day Camper-Please specify Date
Extended Day Hours 6:30am-7:00pm (Additional $25/week)
YES, I wish to sign my child up for the extended camp hours
NO, I do not wish to sign my child up for the extended camp hours
Camp Rotations - Please choose 2:*
Acting Lessons
Music/Dance Lessons
Art Instruction
Cooking/Nutrition
Approved Child Pick Up (Please list first and last names)
Emergency Contact (Please list names, phone numbers, and relation)
Transportation To and From Camp*
---Select---
Parent Drop off/Pick up
Walker/Biker
Friend
Total Fees Due
Payment in full by June 2nd - Payment Type
Check
Cash
Online
Statement of Understanding*
By checking this box I accept and understand that there are 9 weeks of OPMI Summer Camp ($65/per week) beginning June 5th - August 4th. Summer Day camps are from 7:30am-6:00pm, Extended drop off and pick up are from 6:30am-7:30am and 6:00pm-7:00pm which has an additional cost of $25. For a single summer day camp registration (drop off/pick up) the daily fee is $32.50. There will be a onetime registration fee of $20 upon the first week of summer camp sign up. Any portion of the camp that my child cannot attend shall be forfeited without refund or credit. I also understand that I am responsible for picking up my child from camp on time. If I am more than 10 minutes late, I accept and understand that fees will be applied. I also understand that any belongings I send my child to camp with are the responsibility of my child and OPMI nor the Association of Poinciana Villages is responsible for lost, damaged, or stolen items.
Special Needs/Concerns:
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