SUMMER CAMP RATES

June 1 - July 30, 2010 (Closed July 5th)

 

 

 

 

Half Day (7:30 a.m.-12:30 p.m. or 12:30 p.m.-5:25 p.m.)

 

2 Half Days Per Week              $131.00 Per Month

 

3 Half Days Per Week              $194.00 Per Month

 

5 Half Days Per Week              $305.00 Per Month

 

 

 

Full Day (7:30 a.m.-5:25 p.m.)

 

2 Full Days Per Week              $231.00 Per Month

 

3 Full Days Per Week              $326.00 Per Month

 

5 Full Days Per Week              $515.00 Per Month

 

 
 

A late fee of $5.00 per minute will be imposed for pickup after 5:30 p.m.

All fees are due the first of the month and are late after the fifth day of the month.

After the fifth day of the month, a $15.00 per month late fee will be imposed.

Payments are due June 1 and July 1, 2010.

All deposits are non-refundable.

 

 

 

 

 

 

              ____________________________________________________________________________

3275 Maple Valley Road * Morristown, TN  37813 * (423) 586-3280 * Fax (423) 586-9355

www.allsaintsepiscopalschool.org

2010 SUMMER CAMP ENROLLMENT APPLICATION

June 1 – July 30, 2010  (Closed July 5th)

 

STUDENT INFORMATION

 

Last Name                                                                              First Name                                                   Middle Name                                                               

 

   _________________________________________________________________________________________________________________________

   Birth Date                                              Age (2-10 Years Only)                                   Current Grade in 2010/2011 (2 Year Olds-5th Grade Only)                                                                        

 

Status:          □ New  Camper           □ Returning Camper

Gender:          □  Male              □  Female

 

 

 

PARENT/GUARDIAN INFORMATION

 

Father/Guardian                                                                                                   Mother/Guardian

□Mr. □Dr. ________________________________________________          □Mrs. □Ms. □Dr._______________________________________

 

Relationship _______________________________________________            Relationship ____________________________________________

 

Preferred Name ____________________________________________           Preferred Name __________________________________________

 

Social Security Number _____________________________________           Social Security Number ___________________________________

 

Street Address _____________________________________________            Street Address ___________________________________________

 

City, State, Zip _____________________________________________          City, State, Zip ___________________________________________

 

E-Mail Address _____________________________________________         E-Mail Address __________________________________________

 

Employer __________________________________________________         Employer _______________________________________________

 

Occupation/Title ____________________________________________         Occupation/Title _________________________________________

 

Employer’s Address _________________________________________         Employer’s Address ______________________________________

 

City, State, Zip _____________________________________________         City, State, Zip ___________________________________________

 

Home Phone _______________________________________________          Home Phone ____________________________________________

 

Cell Phone _________________________________________________         Cell Phone ______________________________________________

 

Business Phone _____________________________________________          Business Phone __________________________________________

 

Currently enrolled students and their siblings receive priority for enrollment.  Spaces will be reserved on a first-come, first-served basis when a full deposit and application are returned.   Once the Admissions Office has received your signed enrollment agreement and your deposit, you will receive notification when your child has been accepted.  Applications will not be accepted without a $100.00, non-refundable deposit that will be applied to your June payment.

 

 

 

EMERGENCY CONTACT & MEDICAL INFORMATION

Person, other than parent, authorized to act for parent in an emergency:

Name                                                                     

Relationship

Address

Home Phone                                        

Cell Phone

Employer

Business Phone

               

Name of Physician _________________________________________            Phone Number ___________________________________________

 

Name of Dentist ___________________________________________            Phone Number ___________________________________________

Does Your Child Need to Take Medication at Summer Camp?       □ Yes       □ No

Is Your Child Allergic to Anything of Which You Are Aware?        □ Yes        □ No           

If “Yes”, Please List Allergies:  __________________________________________________________________________________________________

 

IMPORTANT NOTE:  All parents must comply with regulations concerning records, such as immunizations, data forms, policies, medical authorization, etc., before students may enter camp.

 

 

TRANSPORTATION RELEASE

To ensure the safety of your child, please list other adults to whom your child may be released or who are authorized to provide transportation for your child.

 

Name _______________________________________    Relationship ____________________    Phone __________________________________

 

Name _______________________________________    Relationship ____________________    Phone __________________________________

 

Name _______________________________________    Relationship ____________________    Phone __________________________________

 

 

GENERAL INFORMATION

Has Your Child Experienced Any of the Following During the Past Year?      □ Moving        □ Birth of a Sibling       

□ Serious Illness in Family          □ Death in Family        □ Separation or Divorce of Parents      □ Other, Please Explain _________________

________________________________________________________________________________________________________________________

Does Your Child Have Any Strong Fears?      □ Yes      □ No          If Yes, Please Explain ____________________________________________

________________________________________________________________________________________________________________________

Does he/she usually get their own way with other children?    □ Yes       □ No

If not, what is the reaction? _____________________________________________________________________________________________________

 

Sibling Name _____________________________________  Age ___________  Applying to ASES Summer Camp    □ Yes         □ No

Sibling Name _____________________________________  Age ___________  Applying to ASES Summer Camp    □ Yes         □ No

Sibling Name _____________________________________  Age ___________  Applying to ASES Summer Camp    □ Yes         □ No

 

Publicity

Unless a letter to the contrary is received by the Head of School, enrollment in All Saints' Episcopal School gives the school administration permission to use your son’s/daughter’s picture on the official school web site and in newspaper advertisements or other publications.

  

    

 

 

 

 

 

      Please Check the Summer Camp Program(s) Your Child Will Attend:

 

    Half Days                                                                      Full Days

□

 

2 Half Days T-TH

□ 7:30 am - 12:30 pm

□12:30 pm – 5:25 pm

 $131 Per Month

□

2 Full Days T-TH

7:30 am - 5:25 pm

 $231 Per Month

□

 

3 Half Days M-W-F

□ 7:30 am - 12:30 pm

□12:30 pm – 5:25 pm

 $194 Per Month

□

3 Full Days M-W-F

7:30 am - 5:25 pm

 $326 Per Month

□

 

5 Half Days M-T-W-T-F

□ 7:30 am - 12:30 pm

□ 12:30 pm – 5:25 pm

 $305 Per Month

□

5 Full Days M-T-W-T-F

7:30 am - 5:25 pm

 $515 Per Month

A late fee of $5.00 per minute will be imposed for pickup after 5:30 p.m.

 

Summer Camp Enrollment Agreement June 1 – July 30, 2010  (Closed July 5th)

The undersigned parties understand that the obligation to pay the fees for summer camp is unconditional and that after May 1, 2010 no portion of fees paid or outstanding will be refunded or cancelled in the event of absence, withdrawal or dismissal of the student from summer camp.  The undersigned agree to assume full responsibility for the full annual summer camp charges and to observe the payment schedule set out on the “Summer Camp Payment Schedule” below.  The undersigned agree to accept the rules and regulations of the School as stated in the Parent/Student Handbook. 

 

If enrollment is cancelled after May 1, 2010 parents or guardians financially responsible for the student are obligated to pay the full annual summer camp charges.

 

 If ASES is notified in writing before May 1, 2010 of a student’s withdrawal, all monies paid may be refunded except for the deposit.  In the event that ASES is unable to provide a space for the student, or the student is not accepted for admission to ASES Summer Camp, all monies paid for the affected student may be refunded including the deposit.

 

Parent’s Signature:   ___________________________________                    Date:  __________________

 

Parent’s Signature:   ___________________________________                    Date:  __________________

 

Enrollment is completed when the school receives a signed Enrollment Agreement and the deposit payment.  Once the Admissions Office has received your signed enrollment agreement and your deposit, we will notify you that your child has been officially enrolled.  Please provide the email address or mailing address to which we should send the notification.    Email address :  _____________________________________________________________

                                      Mailing address: _____________________________________________________________

 

PLEASE COMPLETE:

Summer Camp Payment Schedule

Financial Responsibility is Assumed by

Payment Plan Option

□  Both

 

□  June 1 (Payment will be reduced by your paid deposit)  & July 1

□  Father

All deposits are non-refundable.

□  Mother

 

□  Other   

Name:

Address:

City, State, Zip:

Unless otherwise notified, the Business Manager will e-mail monthly statements in lieu of paper statements.  The e-mail address to be used for billing purposes is:______________________________________________________.

 All fees are due the first of the month and are late after the tenth.  After the tenth day of the month, a $15.00 per month late fee

 is imposed.  Should an account become delinquent by more than 30 calendar days, a student may be asked to stop attending summer camp until payments are made current.  All summer camp payments are expected to be paid in full no later than July 6, 2010.