ROSSMOOR PARK DAY CAMP REGISTRATION FORM

Participant's Name:
Age:
Birthdate:
Gender:
 Male: Female:
Parent's Name:
Home Phone:
Work/Cell Phone
Address:
City:
 Zip:
E-Mail:
Determining your day camp rate code:    1st child
(rate code A) 		2nd child
(rate code B) 		3rd child
(rate code C)

Click for Emergency and Consent Form
Required for all programs
 

WEEK OF
PICK YOUR
DAY CAMP PROGRAM
$15 minimum deposit per week
guarantees enrollment
OPTIONAL FIELD TRIPS
AND ACTIVITIES*
$10 minimum deposit per field trip required
WEEKLY
DEPOSIT
TOTAL
Add up all
deposits**
June 23rd

       Rate code      A  /  B  /  C

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110 



Irvine Boomers!                            $29

Swimming at McGaugh                $10

 $
June 30th

Basic         $76 / $68 / $64

Extended   $96 / $92 / $88

Angels Baseball Game                $22

Trip to Seal Beach                       $10

 $
July 7th

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110

Disneyland                                   $63
       with valid pass                             $15

Swimming at McGaugh                $10

 $
July 14th

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110

Soak City                                      $29

 Trip to Seal Beach                       $10

 $
July 21st

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110

OC Fair (Unlimited Rides)           $48

Swimming at McGaugh                $10
 

 $
July 28th

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110

Knott's Berry Farm                       $29
       with valid pass                              $15

Trip to Seal Beach                       $10

 $
Aug 4th

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110

Wild Rivers                                  $29

Swimming at McGaugh                $10

 $
Aug 11th

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110

Aquarium of the Pacific               $19
       With valid pass                            $10

Trip to Seal Beach                       $10

 $
Aug 18th

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110

Horseback Riding                        $22

Swimming at McGaugh                $10

 $
Aug 25th

Basic         $95 / $85 / $80

Extended   $120 / $115 / $110

AMF Bowling                               $19

 $
  Total Deposits:  $
T-shirt (required for field trips): $  10.00
TOTAL $

Ages
Our program is designed for kids from
5-12 years of age.

Supervision Ratios
Adult leader (18+) to participant
ratio: 10 to 1
Youth leader (14-17) to participant
ratio: 10 to 1
Combined leader to participant
ratio: 5 to 1

Program Hours
Basic program hours:
9:00 a.m. - 4:00 p.m., Mon. - Fri.
Extended program hours:
7:00 a.m.- 7:00 p.m., Mon. - Fri.

Deposits and Weekly Billing**
There is a $15 deposit each for each
week and a $10 deposit for each field
trip or activity. Last minute registration
for field trips and activities is subject to
availability. Balance of weekly tuition is
due at The Youth Center or at camp site by
Wednesday of the week prior to attending.
 Failure to meet deadline will result in
forfeiture of guaranteed space and loss
of all deposits.

On-line Enrollment
Easy enrollment is also available
on-line at TheYouthCenter.org
 
 

* Field trips are limited to the first 60 participants.
** Space is limited. Deposits guarantee space but are neither refundable nor transferrable to other weeks or program elements. All deposits are applied to weekly tuition. Failure to meet deadline will result in forfeiture of guaranteed space and loss of all deposits.


PAYMENT

Carefully type in all digits of your credit card number below (please verify your entries):

Visa MC Card Number
/ Expiration Date (Mo/Yr)
Cardholder's name as it appears on credit card.