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HNGF Summer Camp Junior Counselor Registration
We're so excited you've decided to join us for summer camp this year. For those ages 13-15 we offer a special junior counselor program where students begin to learn the leadership skills and strong work ethic needed to be a counselor.
The cost for summer camp this year is $500 per week for junior counselors. Once you submit this form, you'll receive an invoice in the amount of $100 for the deposit and a liability document to sign and return to us. Please note that the deposit is non-refundable. Once we receive the deposit we'll send you an invoice for the remaining balance which is due the week prior to your first day of camp. If you have any questions or run in to any difficulty with the registration process please email us at
hngfeducation@gmail.com
.
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Email
*
Your email
Week/s you would like to attend
*
Week I (20 - 24 June)
Week II (27 June - 1 July)
Week III (4 - 8 July)
Week IV (11 - 15 July)
Week V (18 - 22 July)
Week VI (25 - 29 July)
Required
Child's First Name
*
Your answer
Child's Last Name
*
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Child is Male or Female?
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Male
Female
Child's Age
*
Your answer
Mailing Address
*
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Parent #1 First Name
*
Your answer
Parent #1 Last Name
*
Your answer
Parent #1 Email
*
Your answer
Parent #1 Telephone Number
*
Your answer
Parent #2 First Name
Your answer
Parent #2 Last Name
Your answer
Parent #2 Email
Your answer
Name of 1st Person to Contact in Case of Emergency
*
Your answer
Telephone Number of 1st Person to Contact in Case of Emergency
*
Your answer
Name of 2nd Person to Contact in Case of Emergency
*
Your answer
Telephone Number of 2nd Person to Contact in Case of Emergency
*
Your answer
List any allergies (food, insect, medicine, etc.)
*
Your answer
Parent #2 Telephone Number
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Physician's Name
*
Your answer
Physician's Telephone Number
*
Your answer
Insurance Company
*
Your answer
Insurance Policy #
*
Your answer
Did you submit a request for financial assistance
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