Flint Hill Farm Ed. Center Kinder Camp Registration 2017 Name

Flint Hill Farm Ed. Center Kinder Camp Registration 2017

Name__________________________________

Address_________________________________

City______________________________ Zip_______

DOB____________ Phone___________Email__________

Father’s Name_____________ Mother’s Name___________

Contact Number (cell or office)_______________________

Doctor’s Name________________Office Number__________

Emergency Contact______________Phone #______________

Allergies__________________ Reactions_________________

Any medical condition/ physical or mental limitations. Prescription medications used presently or during school year

Required 5 campers to run the week. Discount of $5.00 per child for children of same family. Referrals of new campers’ $10.00 gift certificate to use in Farm Store or toward riding lesson. Please circle week or weeks for camps. Please note this gift certificate offer with signup.

June 26-June 30, July 10-14, July 17-21, July 31-Aug 4, Aug 14-18 - Kindercamp

Hours 8:30AM-11:30AM daily. Extended care available for additional charge with advanced notice. Camp is $180.00 with $10.00 discount for registration prior to April 1 (not to be combined with other offers). NON REFUNDABLE deposit of $50.00 per child per week to reserve space. Balance is due 2 weeks prior to start of camp week. As the goal of our camp is to teach children in a safe environment, we reserve the right to cancel summer camp for any child who is unable to follow safety rules. Child should wear appropriate attire for exploring the farm. An additional outfit should be packed. Suggested attire of shorts, sneakers, rain slickers, plus water bottle.

Make checks payable to Flint Hill Farm Educational Center, Inc.

We accept Visa and Mastercard Parent’Signature_____________________Date_________