Child's Name
*
First
Last
Gender
*
Male
Female
Age / Birthday
*
Grade
*
T-Shirt Size
*
T-Shirt
Child Size
Adult Size
School
*
County
*
How do you know about Camp Village?
Friend
Flyer/bulletin
Billboard
Web
Atlanta Parent Magazine
Newspaper
YouTube
Other
Fees
(breakfast, lunch & snacks included in fees):
(50% off, if registered by May 14, 2011)
(50% off, Referrals)
(50% off, Pre-pay Summer Package)
(50% off and 1 week free, if registered for Zamzuu Fundraiser, call
for details)
Before Care & After Care – FREE ($1/minute after 6:05 pm)
Hours of Operation:
Before Care (8 am – 9 am)
Program (9 am-4 pm)
After Care (4 pm-6 pm)
Extended Care :
Before Care
After Care
Transportation
Select, if transporation need from:
Downtown–The APEX Museum/135 Auburn Avenue, Atl., GA 30303
Camp location:
Southwest–Carver Bible College/3870 Cascade Road, Atl., GA 30331
(HEADQUARTERS’ CAMPSITE)
Parent's Name
*
First
Last
Address
*
Street Address 1
City
State / Province / Region
Zip / Postal Code
Phone
*
Cell
*
Email
*
Relative (Relationship)/Guardian’s Name(s)
*
First
Last
Address
*
Street Address 1
City
State / Province / Region
Zip / Postal Code
Phone
*
Cell
*
Email
*
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Please check the Weekly Session (s) you are requesting:
*
SESSION 1 (June 6 – June 10)
SESSION 2 (June 13 – June 17)
SESSION 3 (June 20 – June 24)
SESSION 4 (June 27 – July 1)
SESSION 5 (July 5 – July 8)
SESSION 6 (July 11 – July 15)
SESSION 7 (July 18 – July 22) CAMP VILLAGE GO TO
DISNEY WORLD!(call for details)
Total Summer Package (6 wks) with
After Care ($1,350) or SAVE 25%
Pre-pay Summer Package (6 wks) with After Care ($1,012.50)
Total Summer Package (6 wks) without
After Care ($1,050) or SAVE 25%
Pre-pay Summer Package (6 wks) without After Care ($787.50)
Please call (404) 349-0122 for credit card payments and make checks/money orders payable to Camp Village, Inc.
Please mail payments to:
Camp Village, Inc. c/o Jo R. Edwards P.O. Box 110188 Atlanta, GA 30311
404. 349.0122/office --------- 404.758.4003/fax ---------- info@campvillage.com/email