OverNight Camp
SUMMER CAMP 2009

On-Line Early Registration Form

Thank you for choosing Camp Frontier's On-Line Registration.
Please complete ONE Registration Form for EACH Child attending.

SIGN-UP with Payment in Full
and save $200 before January 31st!

CAMPER INFORMATION
CAMPER'S LAST NAME
CAMPER'S FIRST NAME
MAILING ADDRESS
CITY
STATE
ZIP/POSTAL CODE
 COUNTRY
DATE OF BIRTH   mm/dd/yy
AGE UPON ARRIVAL
AT CAMP
US Citizens Only
used for Medical Purposes Only

SOCIAL SECURITY NUMBER
SEX
BOY
GIRL
PARENT'S NAME(s)
CHILD LIVES WITH

(ie. Mother and Father, Father, Mother, Father and Step-Mother, Father and Step-Mother, Grandparents)
FATHER'S NAME
MOTHER'S NAME
FATHER'S
HOME PHONE NUMBER
MOTHER'S
HOME PHONE NUMBER
FATHER'S
WORK PHONE NUMBER
MOTHER'S
WORK PHONE NUMBER
FATHER'S
CELL PHONE NUMBER
MOTHER'S
CELL PHONE NUMBER
FATHER'S
eMAIL ADDRESS
MOTHER'S
eMAIL ADDRESS

Please provide any information which will assist us in providing a
great experience for your child. (Do not provide medical information here.)


There are now two ways to SAVE!

1)
SAVE $200 (per session)
with Payment-In-Full
- OR -
2)
SAVE $100 (per session)
with Deposit of $400 and
four (4) monthly payments of $250

OverNight Camper Registration
PAYMENT IN FULL

SAVE $200 Per Session
SESSION 1 (Two Weeks) ~ $1600
Sun, June 14 - Sat, June 27
Busch Gardens Field Trip
SAVE
$200
Pay Only
$1400
SESSION 2 (Two Weeks) ~ $1600
Sun, June 28 - Sat, July 11
Sea World Field Trip on July 4th
SAVE
$200
Pay Only
$1400
SESSION 3 (Two Weeks) ~ $1600
Sun, July 12 - Sat, July 25
Universal Studios or Islands Of Adventure
SAVE
$200
Pay Only
$1400

SESSION 4 (Two Weeks) ~ $1600
Sun, July 26 - Sat, August 8
Disney World Field Trip

SAVE
$200

Pay Only
$1400

OverNight Camper Registration
with Deposit of $400 and
four (4) monthly payments of $275
SAVE $100 Per Session
SESSION 1 (Two Weeks) ~ $1600
Sun, June 14 - Sat, June 27
Busch Gardens Field Trip
SAVE
$100
Pay Only
$400
DEPOSIT
& $275/mo
SESSION 2 (Two Weeks) ~ $1600
Sun, June 28 - Sat, July 11
Sea World Field Trip on July 4th
SAVE
$100
Pay Only
$400
DEPOSIT
& $275/mo
SESSION 3 (Two Weeks) ~ $1600
Sun, July 12 - Sat, July 25
Universal Studios or Islands Of Adventure
SAVE
$100
Pay Only
$400
DEPOSIT
& $275/mo

SESSION 4 (Two Weeks) ~ $1600
Sun, July 26 - Sat, August 8
Disney World Field Trip

SAVE
$100

Pay Only
$400
DEPOSIT
& $275/mo

Monthy tuition payments to be charged to the credit card provided
starting the month following this registration with deposit.

ADDITIONAL AIRPORT FEES
Please coordinate flight schedule with the
Camp Office before purchasing airline tickets
as transportation is available durring
certain hours only.

AIRPORT TRANSPORTATION
Pick-Up Camper FROM the
Tampa International Airport
$50

Bring Camper TO the
Tampa International Airport

$50
FAMILY DISCOUNTS

FAMILY DISCOUNT

$100 Family Discount for more than one child attending. All children after the first are eligable.

PLEASE PROVIDE PAYMENT INFORMATION
NAME as it appears on your Credit Card
E-MAIL ADDRESS of the Card Holder
STREET ADDRESS
to which your Credit Card is billed

TELEPHONE NUMBER
CITY to which your Credit Card is billed
ZIP/POSTAL CODE
to which your Credit Card is billed

STATE OR PROVINCE
COUNTRY

Unfortunately, our web software does not total up your tuition automatically.
Please calculate the above options and enter the amount here. Remember to take all applicable discounts.

I authorize the following charges to my credit card.
TOTAL PAYMENT AT THIS TIME $

Your Credit Card Number
Card Verification Value

What is this?
Expiration Date
Month
Year
Select the type of Credit Card
Visa Master Card American Express Discover Card
Any comments relating to your payment

REGISTRATION AGREEMENT
 
The above provided information is correct and complete to the best of my knowledge. I/We have read and understand the terms, policies and requirements of attending Camp Frontier and understand that signing this agreement confirms compliance. I/We give complete authorization for a representative of Camp Frontier to request and receive any medical treatment in the event of need. I/We accept full responsibility for the payment of all medical services provided. I/We release and hold blameless the employees, volunteers, and Board of Directors of Camp Frontier, Inc. from any and all claims of liability past, present and/or future. I/We accept the financial responsibility for any and all damage to facilities or personal property for which our Child is found to be responsible. I/We acknowledge that Camp Frontier, Inc. owns and has discretion over the use of all photographs and recordings created while the child is at camp. I/We understand that the total Tuition must be paid in full two weeks in advance to the scheduled arrival date and authorize the balance due (if any) to be charged to the provided credit card two weeks prior to arrival. I/We understand that any and all deposits, fees and or tuition amount paid is non-refundable even should the camper not attend, go home during camp or be expelled due to dishonest, disrespectful, inappropriate and/or violent behavior.


 Please Type Your Name To Accept The Terms Of Enrollment  (required)
 


PLEASE SUBMIT ONLY ONCE.

Press  and your Registration Form will be processed
or  to erase and start again.

THANK YOU!