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6 2012 Flex Camp Registration Section To register for Flex Camp, complete this section first.


• Select week and day options you wish to sign up for by checking the appropriate boxes below. (If you wish to have your camper attend camp for a full week, register them for both the M/W/F and Tu/Th options.) • Select whether or not you want to enroll in Before Camp Care or After Camp Care


B A as described on pg 2. To enroll, check the box or boxes and add this to your total fees.


• Add up the fees for all weeks selected and record total in Total Fee space at the bottom of this page. • If you elect to pay a deposit instead of the entire balance, calculate the total deposit and balance due and record at the bottom of this page. • After April 1, fees must be paid in full. Balance due will be charged to credit card on May 1. • Transfer all fee, deposit and balance due information to section 2B, on the reverse of this page. • Complete sections 1, 2C, 3, 4 and 5 on the reverse of this page.


Please complete one form for each child you are enrolling in Flex Camp. Additional forms can be obtained at Park Center or downloaded from the Glenview Park District website at glenviewparks.org. Note: grade/age listed is the grade/age at the time of registration.


= Register by Feb. 29 and pay the Early Bird rate! Registrant’s first name: __________________________ Registrant’s last name: ____________________________ Sex M___ F___ Birthdate: ______________ Grade: ______ Crowley Park


Playtime Pals ages 4- entering Kindergarten ID #503412


B


3 Day Option, M/W/F


Select week(s) Week 1 6/11-6/15


Week 2 6/18-6/22 Week 3 6/25-6/29 Week 4 7/2-7/6* *No camp 7/4


Week 5 7/9-7/13 Week 6 7/16-7/20


2 Day Option, Tu/Th


Select week(s)


Week 2 6/19-6/21 Week 3 6/26-6/28 Week 4 7/3-7/5 Week 5 7/10-7/12


Section EB FEE FEE (R/NR) (R/NR)


A  $62/68 $67/84 $15 B  $62/68 $67/84 $15 C  $62/68 $67/84 $15 D  $41/52 $46/51 $15


E  $62/68 $67/84 $15 F  $62/68 $67/84 $15


Week 7 7/23-7/27 G  $62/68 $67/84 $15 Section EB FEE FEE (R/NR) (R/NR)


Week 1 6/12-6/14 H  $41/52 $46/51 $15 I  $41/52 $46/51 $15 J  $41/52 $46/51 $15 K  $41/52 $46/51 $15 L  $41/52 $46/51 $15


Week 6 7/17-7/19 M  $41/52 $46/51 $15 Week 7 7/24-7/26 N  $41/52 $46/51 $15


Total of fees and


deposits for all Flex Camp sections you are paying today.


Total Fee $________


Total Deposit $________ *Balance Due $________ (total fee minus deposit)


DEP. DEP. Pleasant Ridge


Playtime Pals ages 4- entering Kindergarten ID #507041


B Section EB FEE FEE (R/NR) (R/NR)


A  $62/68 $67/84 $15 B  $62/68 $67/84 $15 C  $62/68 $67/84 $15 D  $41/52 $46/51 $15


E  $62/68 $67/84 $15 F  $62/68 $67/84 $15 G  $62/68 $67/84 $15


Section EB FEE FEE (R/NR) (R/NR)


H  $41/52 $46/51 $15 I  $41/52 $46/51 $15 J  $41/52 $46/51 $15 K  $41/52 $46/51 $15 L  $41/52 $46/51 $15


Pleasant Ridge


Sun Troopers grades K-1 ID #507043


DEP. Section EB FEE FEE (R/NR) (R/NR)


A  $117/129 $122/134 $15 B  $117/129 $122/134 $15 C  $117/129 $122/134 $15 D  $78/86


$83/91 $15


E  $117/129 $122/134 $15 F  $117/129 $122/134 $15 G  $117/129 $122/134 $15


DEP. Section EB FEE


H  $78/86 I  $78/86 J  $78/86 K  $78/86 L  $78/86


M  $41/52 $46/51 $15 M  $78/86 N  $41/52 $46/51 $15


N  $78/86 Total Fee $________


Total Deposit $________ *Balance Due $________ (total fee minus deposit)


FEE


(R/NR) (R/NR) $83/91


$83/91 $83/91 $83/91 $83/91 $83/91 $83/91


A B


Pleasant Ridge


Fun Quest grades 2-4 ID #507042


DEP. Section EB FEE FEE (R/NR) (R/NR)


A  $117/129 $122/134 $15 B  $117/129 $122/134 $15 C  $117/129 $122/134 $15 D  $78/86


$83/91 $15


E  $117/129 $122/134 $15 F  $117/129 $122/134 $15 G  $117/129 $122/134 $15


DEP. Section EB FEE


$15 $15 $15 $15 $15


$15 Total Fee $________


Total Deposit $________ *Balance Due $________ (total fee minus deposit)


H  $78/86 I  $78/86 J  $78/86 K  $78/86 L  $78/86


$15 M  $78/86 N  $78/86


FEE


(R/NR) (R/NR) $83/91


$83/91 $83/91 $83/91 $83/91 $83/91 $83/91


DEP.


$15 $15 $15 $15 $15 $15 $15


Total Fee $________


Total Deposit $________ *Balance Due $________ (total fee minus deposit)


Record the total of above fees and deposits above and in section 2B, on the reverse side of this form. Return form to Park Center, 2400 Chestnut Ave., Suite P, Glenview, IL 60026 • Fax: (847) 657-6231. Additional forms are available at Park Center.


A B


Check box(es) for the option(s) you want.


Before Camp Care


B


M/W/F (R/NR)


DEP. Fee:


 


**


After Camp Care


A


M/W/F (R/NR)


Fee:


$27/30 $41/45 


  


**$18/$20 **$28/$31   


** 


 


Tu/Th (R/NR) Fee:


     


Total Before


Camp Care Option


$________


Tu/Th (R/NR) Fee:


$18/20 $28/31 


      


Total After


Camp Care Option


$________


Please add these amounts to the totals fee.

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