PBJC Day Camp Summer 2024 Enrollment Application

* Child's First Name:

* Child's Last Name:

* Date of Birth:

* Parent/Guardian 1 First Name:

* Parent/Guardian 1 Last Name:

Parent/Guardian 1 Home Phone Number:

* Parent/Guardian 1 Mobile Phone Number:

* Parent/Guardian 1 Email Address:

Parent/Guardian 2 First Name:

Parent/Guardian 2 Last Name:

Parent/Guardian 2 Home Phone Number:

Parent/Guardian 2 Mobile Phone Number:

Parent/Guardian 2 Email Address:

* Home Address:

* City:

* Zip:

2024 PBJC Day Camp Terms of Enrollment

*Camp expenses are incurred whether or not a camper attends; therefore, refunds will not be made for absences, dismissals or withdrawls from the camp program.
*No refunds will be given if the camp is closed due to emergencies or holidays.
*Campers not paid in full by July 1, 2024 will incur a $50 per month late fee.
*Camp is not responsible for loss or damage to belongings brought to camp. Please label everything.
*Camp may photograph campers and has the right to use these photographs in camp brochures and media material.
*Permission is granted for child to participate in all camp activities.
*Medical forms MUST be submitted prior to June 1, 2024 with all necessary information and signatures.
*A copy of an original birth certificate MUST accompany registration for any NEW CHILD registering for camp.

* Virtual Signature. By writing my name below, I acknowledge that I have read all of the information on this registration form and agree to the terms and conditions herein.

Please select which weeks your child will be attending camp. Please select all that apply.

Week 1 - June 24 through June 28Week 2 - July 1 through July 5 (Camp is closed on Thursday, July 4)Week 3 - July 8 through July 12Week 4 - July 15 through July 19Week 5 - July 22 through July 26Week 6 - July 29 through August 2Week 7 - August 5 through August 9Week 8 - August 12 through August 16

EXTENDED DAY OPTION: Check here if you plan to enroll your child in the PBJC Day Camp Extended Day Option. Extended day runs from 2:30 PM to 5:00 PM Monday through Friday. The cost is $250/week (based on $50/day). If you enroll in the program, you MUST enroll for all 5 days and for every week your child attends camp.

* Please enroll my child for the 2024 summer. I agree to pay a $300 deposit at the time of registration, which will be applied towards camp tuition.

Please enroll my child for the 2024 summer. I agree to pay a $300 deposit at the time of registration, which will be applied towards camp tuition.2024-2025 PBJC Day Camp Registration

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