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Girl Camp Auxilium
Registration Form
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* Indicates required question
Email
*
Your email
1st Child
Camper Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Age
Choose
4
5
6
7
8
9
10
11
12
13
2nd Child (additional sibling)
Same Family
Camper Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Age
Choose
4
5
6
7
8
9
10
11
12
13
FAMILY INFORMATION
Address (street)
Your answer
City, State, Zip Code, Country
Your answer
Father's Name
Your answer
Father's Phone Number(s)
Your answer
Father's Email address
Your answer
Mother's Name
Your answer
Mother's Phone Number(s)
Your answer
Mother's Email Address
Your answer
CAMP FEES
Weekly
Registration Fee (one time & non-refundable)
1st Child $75.00
2nd Child $75.00
Registration Fee
1st Child $75.00
2nd Child $75.00
Registration Fee
Weekly Resident Camp Fee
Week 1
Week 2
Week 3
Week 4
Resident Camper Fee $425.00 per week
Additional Sibling Fee $390.00 per week
Week 1
Week 2
Week 3
Week 4
Resident Camper Fee $425.00 per week
Additional Sibling Fee $390.00 per week
Weekly Day Camp Fee
Week 1
Week 2
Week 3
Week 4
Day Camper Fee $275.00 per week
Additional Sibling Fee $240.00 per week
Week 1
Week 2
Week 3
Week 4
Day Camper Fee $275.00 per week
Additional Sibling Fee $240.00 per week
OTHER EXPENSES:
Weekly Canteen Card
Week 1
Week 2
Week 3
Week 4
1st Child $10.00/week
2nd Child $10.00/week
Week 1
Week 2
Week 3
Week 4
1st Child $10.00/week
2nd Child $10.00/week
Camp T-Shirt $20.00
XS
S
M
L
XL
XXL
1st Child $15.00 each
2nd Child $15.00 each
XS
S
M
L
XL
XXL
1st Child $15.00 each
2nd Child $15.00 each
Camp Sweat Shirt $30.00
XS
S
M
L
XL
XXL
1st Child $30.00 each
2nd Child $30.00 each
XS
S
M
L
XL
XXL
1st Child $30.00 each
2nd Child $30.00 each
Swim Cap (Lycra) $10.00
Red (Beginner)
White (Intermediate)
Blue (Advanced)
1st Child $10.00 each
2nd Child $10.00 each
Red (Beginner)
White (Intermediate)
Blue (Advanced)
1st Child $10.00 each
2nd Child $10.00 each
Camp Picture 8x10 $5.00 each
Week 1
Week 2
Week 3
Week 4
1st Child $5.00 each
2nd Child $5.00 each
Week 1
Week 2
Week 3
Week 4
1st Child $5.00 each
2nd Child $5.00 each
Laundry Service (per week, per child, per load)
Week 1
Week 2
Week 3
Week 4
1st Child $15.00
2nd Child $15.00
Week 1
Week 2
Week 3
Week 4
1st Child $15.00
2nd Child $15.00
Airport Pick Up
Arrival
Departure
Per person $60.00 per trip
Per Family in vehicle $80.00 per trip
Arrival
Departure
Per person $60.00 per trip
Per Family in vehicle $80.00 per trip
PAYMENT
Methods of Payment
Cash
PayPal
Credit Card
Check
My payment is
Cash
PayPal
Credit Card
Check
My payment is
Check no.
Your answer
Medical/Liability Forms
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