APPLICATION FORM 2008
(Please print out this form and send with your enrollment check)
FULL DAY SESSION (8:30am - 2:30pm) - $260
1/2 DAY SESSION (8:30am - 12:00 noon) - $220
Session I - Monday July 21 - Friday July 25
Session II - Monday July 28 - Friday August 1
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Full Day ____ 1/2 Day ____ (If attending multiple sessions, please check each session desired) Age: _______ Male _____ Female _____ Mailing Address: _____________________________________________ City: _______________________________________________________ State: ___________________________________ Zip Code: ___________ School: ____________________________________ Grade: ___________ Home Phone: ________________ Emergency Phone: __________________ Insurance Carrier: _____________________________________________ T-Shirt Size: ______________ Please enroll my son/daughter in your Mid-Cape Hoop School. I understand that the Dennis-Yarmouth Regional School District, Chatham School System, Mid-Cape Hoop School co-directors, staff or anyone associated with this camp will not assume responsibility for accidents and medical or dental expenses incurred as a result of participation in this program. The applicant is covered by our family insurance, is in good health and able to participate in the physical activity or a vigorous program. I, hereby, authorize the camp directors to act for me according to their best judgement in any emergency requiring medical attention. PARENT'S SIGNATURE: X_______________________________________________DATE____/____/____ |
Send Form & Non-Refundable Tuition or $100 Deposit Payable To:
Mid-Cape Hoop School
c/o Bob Hamilton
40 Sheffield Road
West Yarmouth, MA 02673
508-394-4039
info@midcapehoopschool.com