Mount Hermon Full-time & Eligible Part-time Staff
2010 SUMMER SEASON REGISTRATION FORM
Mount Hermon Full-time & Eligible Part-time Staff
2010 SUMMER SEASON REGISTRATION FORM
CHILD CARE, DAY CAMP, JR HIGH, HIGH SCHOOL CONTINUOUS WEEK SELECTION
______________________________________________________________
Please make two Family Camp date choices: First Choice: __________________________________________
Name _______________________________________________________________
Second Choice: _______________________________________
Spouse’s Name _______________________________________________________________
Please list the names and birth dates of children in your immediate family (do not include grandchildren or grown children living at home.)
Mailing Address ________________________________________________________________ City State Zip ________________________________________________________________
_______________________________________________________________ Child’s Name Birth Date Child Care Day Camp Jr. High High School
Mount Hermon Residence Address ________________________________________________________________ Phone Number ________________________________________________________________ Email address Please select one (See information booklet for details): Summer Season Registration adult $95.00/child $110.00 NOTE: Immediate Family maximum of $330.00 Auditorium Attendance Only–Resident Day Registration please come to the Registration Office
________________________________________________________________ Child’s Name Birth Date Child Care Day Camp Jr. High High School ________________________________________________________________ Child’s Name Birth Date Child Care Day Camp Jr. High High School ________________________________________________________________ Child’s Name Birth Date Child Care Day Camp Jr. High High School ________________________________________________________________ Child’s Name Birth Date Child Care Day Camp Jr. High High School