Sunrock Farm Camp Registration

Summer Day Camps – 2008

Phone: 859-781-5502 Fax: 859-572-0260 Address: 103 Gibson Lane, Wilder, KY 41076

Check the appropriate session(s)

Traditional Camp: 9:30-2:30* Pre-K Camp: 9:30-1:30** Youth Camp: 9:30-2:30

*Session 1: June 9-13___ Session 1: June 9-11____ Session 2: June 16-20 ____

Session 2: June 16-20 ___ Session 2: June 16-18____ Session 4: July 7-11____

Session 3: June 23-27 ___ Session 3: June 23-25____ Session 8: August 4-8___

Session 4: July 7-11 ___ Session 4: July 7-9____

Session 5: July 14-18 ___

Session 6: July 21-25___

Session 7: July 28-August1 ___ Camp begins at 9:30 am. Drop off no earlier than 9:15.

*Traditional camp ONLY.___ I would like to participate in the extended hours program for session 1.(8:30am-5:30pm)

**Pre-K camp ONLY.____ I would like to participate in Pre-K added hour program.. ($15.00 extra per day)

Child’s name (include form of name child prefers) :__________________________________________________________

Name of parent(s) or guardian(s): ______________________________________________________________________

Address: ________________________________________________________________________________

(Street #) (City, State) (Zip)

Home Phone: ( )_____________ Work phone: ( )______________Cell Phone: ( )_____________ EMAIL_______________

Child’s grade (Fall, ’08) ____ Child’s age on 1st day of camp session ____ Child’s date of birth: ____________

In case of emergency, we will call the above phone numbers then: (please list an alternate:)

Name: ________________________________________ Phone: ( )_______________________

Family Physician: Name: ___________________________ Phone: ( )_________________________

Does the child have allergies, special needs, or any other restrictions? ____ Yes ____ No

If “yes”: What are these ______________________________________________________________________

(If needed, please use other sheets of paper to describe the restrictions.)

Sunrock Farm reserves the right (1) to refuse registration for health reasons. For example, the farm environment may not be good for

children with severe hay allergies; (2) to cancel (with pro-rated refund) a camper's attendance for health or disciplinary reasons.

FEES: TRADITIONAL FARM CAMP: $195/WEEK PREK CAMP: $150/ M,T,W only YOUTH CAMP: $225/WEEK,

EXTENDED HOURS FARM CAMP Week 1 traditional only $315/WEEK.

Make checks payable to Sunrock Farm, 103 Gibson Lane, Wilder, KY 41076. Sorry, no credit cards accepted.

You will receive a confirmation packet, via Email or regular post, with information/ suggestions within two weeks of sending the registration.

If a refund is necessary, a $40/camper processing fee will be charged. The balance of the fee is refundable ONLY in the case of

serious illness or accident (with a physician’s statement), death in the immediate family, moving out of the area, or the child is required

to attend summer school. Appropriate documentation is required. If a session enrollment is low, the session will be cancelled and fees returned.

“I agree not to send my child to summer day camp unless she/he is in good physical condition and has not been exposed to

a communicable disease. My child has permission to receive emergency medical care. I understand that photos of camp activities

may be taken during the course of the summer and used in farm advertising and publications."

Signature of parent/guardian ____________________________________________________ Date:_______________

Comments & special requests: _____________________________________________________________________________