Westview on the James

Summer Camp 2007

Camper Name__________________________ Date Of Birth ___________

Boy ___ Girl ___  Age (as of camp) _____

Address _____________________________City ___________Zip_______

Parents Names _______________________________________________

Home Telephone ______________Church Camper Attends ___________

Work Telephone _______________(Mother/Father) Fax_______________

Cell #_____________________ Parent-Email_______________________

Church Scholarship?  ____Yes ____No   If yes, how much? $ _________

 

"Buddy" Preference (If you desire one) _______________________________    

                          (Only one of same grade/age who must also request you)

 

Eligible for: ____ 1. Sibling Discount__________________________________________

                                                                                Name/Age/Program # Attending

        

                  ____ 2. "Bring a Buddy Discount ___________________________________

                                                                               Name/Age/Program # Attending

Name of siblings attending Westview this Summer: __________________________

Please enroll me in:

______________________       ______________________

Wk #              Program #    Date of Session          Wk #       Program #          Date of Session

 

___________________________________      _________________________________

Wk #              Program #    Date of Session          Wk #       Program #          Date of Session

Office Use Only

Deposit Amt. $ _____   Check No.  _____   Date Rec'd   _____

Packet Sent     _____   Discounts $_____   Scholarship $_____

Payment       $ _____   Bal. Due  $_____