VBS Child Registration Form - Cover Page

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AGAPE Summer Day Camp

Boon Church of OCM

05/18/12 50 ( 6-7 )(718)445-7640 0 Dear Parents: Greetings to you all. Though the summer is still a few months away, it is already time to begin registering for the Agape Summer Day Camp. You are eligible to receive a $50 discount from the camp fees for the first child in your family who registers before 05/18/12. Included below are the fees for the summer camp. For more information see back for details or call (718) 445-7640 and dial0. Thank you. (,)
Age: K to 8th Grade Dates: 2012 7 week session: July 2 ~ Aug. 17, 2012 (One day off on Independence Day July 4) Time: 9:00 AM ~ 5:00 PM (Monday ~ Friday) Check Payable to: Boon Church of OCM Early Bird Date: Register before May 18, 2012 (6-7 week session only - $50 discount for 1st child) Registration fee: $50 (non-refundable) Tuition fee: K to G5 6 weeks: $610 7 weeks: $685 7 weeks: $720 G6 to G8 - 6 weeks: $640 $50 discount for 2nd Child 6 week session: July 2 ~ Aug. 10,

() () Boon Church of OCM : ( 6-7 50 ) $50 () * : --$610 --$685 () * : --$640 --$720 () 50 100 43-72 Bowne Street Flushing, NY 11355) Tel. (718) 445-7640 Ext. 0 Fax: (718) 445-5323

Discount for children from the same family:


$100 discount for 3rd Child Site: Boon Church 43-72 Bowne Street, Flushing, NY 11355

Contact: Church Office Tel.: Church Fax: (718) 445-7640 Ext. 0 (718) 445-5323

Transportation to camp is not Provided Please complete the attached Health Form Children will not be able to attend the camp without a completed health form.


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4. : $2 30 5. , 6. $30

submitted at the time of registration. These forms must be signed and have an emergency contact phone number. 3. Refunds: $50 Registration fee is nonrefundable

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Refunds after camp opens: Refunds will be based on total weeks registered and total weeks attended. Note that, the total time attended is calculated by weeks not by number of days. NO refunds will be given after 07/13/12. Student must be picked before 5:15 PM. From 5:15 PM to 6:00PM there is a charge of $2/child per day. After 6:00PM, there is an additional $5/child every 30 minutes. Please have 1 small blanket and 1 small pillow ready for Kindergarten students on camps opening day for their daily nap times. We will not provide blankets or pillows. 7. Student who do not follow the rules of Registration Information camp, or adapt to the class will be dismissed, and fees refunded according to Each student must have a registration form the refund policy. filled by parent. 8. There is a $30.00 fee charge for Physical examination forms must be returned checks.
NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE DIVISION OF ENVIRONMENTAL HEALTH BUREAU OF FOOD SAFETY AND COMMUNITY SANITATION 253 BROADWAY, 12TH FLOOR, CN 59A NEW YORK, N.Y. 10007 (212) 676-1600

Below is the recommended written statement that must be provided by each camp to all parents or guardians declaring that the camp is licensed by the New York City Department of Health and Mental Hygiene. (NYCHC

PARENT INFORMATION STATEMENT

Agape Summer Day Camp


(Name of Camp)

43-72 Bowne Street, Flushing, NY 11355


(Address)

This camp is licensed by the New York City Department of Health and Mental Hygiene and is instpected twice yearly. The inspection reports are filed at the Bureau of Food Safety and Community Sanitation.

Section 48.29)

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