Sunrock Farm Camp Registration- Summer 2010

Phone: 859-781-5502 Fax: 859-572-0260 Address: 103 Gibson Lane, Wilder, KY 41076

Check the appropriate session(s) Camp begins at 9:30 am. Drop off no earlier than 9:15.

Traditional Camp: 9:30-2:30* Pre-K Camp: 9:30-1:30** Youth Camp: 9:30-2:30

Session 1: June 14-18___ Session 1: June 14-16____ Session 2: June 21-25 ____

*Session 1 extended:___ Session 2: June 21-23____ Session 4: July 12-16____

Session 2: June 21-25 ____ Session 3: June 28-30____ Session 6: July 26-30____

Session 3: June 28-July 2___ Session 4: July 12-14____

Session 4: July 12-16 ___

Session 5: July 19-23 ___

Session 6: July 26-30___

NEW!!  Parent/camper day: July 9 ___   Alumni Day:  August 4___   NEW!!

* Extended traditional camp____ My child will be participating in session 1 extended hours, 8:30am – 5:30pm. Cost $325.

**Pre-K camp ONLY.____ My child will participate in Pre-K added hour program.. ($15.00 extra per day)

(PLEASE PRINT)

Child’s name (include nickname):___________________________________________________________________________________

Name of parent(s) or guardian(s): __________________________________________________________________________________

Address: ____________________________________________________________________________________________________

(Street #) (City, State) (Zip)

Home Phone: ( )_______________________________ Work phone: ( )_____________________________________

Cell Phone: ( )_________________________________ EMAIL: ______________________________________________

Child’s last grade completed ____ Child’s age on 1st day of camp session ________ Child’s date of birth: ______________________

In case of emergency, we will call the above phone numbers then: (please list an alternate:)

Name: ______________________________________________________________ Phone: ( )_______________________

Family Physician: Name: _________________________________________________ Phone: ( )_________________________

Does the child have allergies, special needs, or any other restrictions? ____ Yes ____ No

If “yes”: What are these ________________________________________________________________________________________

(If needed, please use other sheets of paper to describe the restrictions.)

Sunrock Farm reserves the right (1) to refuse registration for health reasons. For example, the farm environment may not be good for children with

severe hay allergies; (2) to cancel (with pro-rated refund) a camper's attendance for health or disciplinary reasons.

FEES: TRADITIONAL FARM CAMP: $195/WEEK PREK CAMP: $150/ M,T,W only YOUTH CAMP: $225/WEEK,

EXTENDED HOURS FARM CAMP Week 1 traditional only $325/WEEK.  PARENT/CAMPER DAY: S50/CAMPER, $40/ PARENT .  ALUMNI DAY: $50/ALUMNI

Make checks payable to Sunrock Farm, 103 Gibson Lane, Wilder, KY 41076. Sorry, no credit cards accepted.

You will receive a confirmation packet, via Email or regular post, with information within two weeks of sending the registration.

If a refund is necessary, a $40/camper processing fee will be charged. The balance of the fee is refundable ONLY in the case of

serious illness or accident (with a physician’s statement), death in the immediate family, moving out of the area, or if the child is required to

attend summer school. Appropriate documentation is required. If a session enrollment is low, the session will be cancelled and fees returned.

“I agree not to send my child to summer day camp unless she/he is in good physical condition and has not been exposed

to a communicable disease. My child has permission to receive emergency medical care. I understand that photos of camp activities

may be taken during the course of the summer and used in farm advertising and publications."

Signature of parent/guardian ____________________________________________________ Date:_______________

Comments & special requests: _____________________________________________________________________________