Please fill out all applicable information       (*required field)

 
    Banner Day Camp is excited to offer extended day camp care until 5:30 pm Monday – Thursday and 5:00 pm Fridays. Campers will be given an after camp snack and will participate in a choice of activities including crafts, sports, games and imaginative play time. Activities will be fully supervised by camp counselors and leadership team members. The cost is an additional $5 per each half hour of care starting at 4:00 pm until 5:30 pm (Monday – Thursday) and 4:00 pm until 5:00 pm (Fridays).
   
         
    Home Phone Number *    
           

 

 

  Camper 1    
  Last Name*   First Name *    

 

  After Camp Weekly Schedule              
  Mondays Tuesdays Wednesdays Thursdays Fridays

 

 

  Camper 2    
  Last Name*   First Name *    

 

  After Camp Weekly Schedule              
  Mondays Tuesdays Wednesdays Thursdays Fridays

 

 

  Camper 3    
  Last Name*   First Name *    

 

  After Camp Weekly Schedule              
  Mondays Tuesdays Wednesdays Thursdays Fridays

 

 

 

  Authorized to Pickup from Extended Day Please list anyone who is authorized to pick up from extended day including parents.
  Name Relation Contact Phone Number
  Name Relation Contact Phone Number
  Name Relation Contact Phone Number
  Name Relation Contact Phone Number
         

 

 
  Payment *    
  A $100 deposit per camper is required.  

   

  Credit Card Information *     
  Name (as appears on card)*   Phone*          
  Street Address*   City*   State* Zip Code*  
 

Card Type

 

Account Number*

         
 

Exp. Date*

 

CVV2/CVC2 (security #)*

         
                   
 

Terms and conditions

I understand that part of the camping experience involves activities and group interactions, and come with uncertainties beyond what my child may be used to dealing with. I am aware of these risks, and I am assuming them on behalf of my child. I realize that no environment is risk-free, and so I have instructed my child on the importance of abiding by the camp’s rules, and my child and I both agree that he or she is familiar with these rules and will obey them.

I further agree to allow my child to be used in any promotional photography (newsletter, brochure, video, web site, etc.).

 

I agree that any dispute concerning, relating, or referring to this contract, any representation concerning my child’s camping experience, or the camping experience itself shall be resolved exclusively by binding arbitration in Lake County, Illinois, according to the then existing commercial rules of the American Arbitration Association and the substantive laws of that state.

                 
    I agree to the above terms and conditions *        
      
                 
 
             

 

       

 

 
 
 
copyright © 2008 Banner Day Camp. All rights reserved.