APPLICATION FOR CORBIN'S CRUSADERS SPORTS CLUB
For School Vacation and Other Day Camp Please fill out Day Camp Application


CHILD INFORMATION
 Childs Name:    Gender:   Male   Female
 Age:    Date of Birth:    Grade:  
 Sibling #1 Name:   Age:  
 Sibling #2 Name:   Age:  
 Sibling #3 Name:   Age:  
FAMILY INFORMATION
 Mother's Full Name:    Father's Full Name:  
 House Street Address:    Apt#:  
 Cross Street(s):  
 City:    Zipcode:  
 Home Phone:
(xxx-xxx-xxxx)		    Cell Phone:
(xxx-xxx-xxxx)		  
 Fax:
(xxx-xxx-xxxx)		    Business Phone:
(xxx-xxx-xxxx)		  
 Email Address:  
 Business Address:  
 City:    Zipcode:  
EMERGENCY/MEDICAL INFORMATION
 Emergency Contact:    Emergency Phone:
(xxx-xxx-xxxx)		  
 Family Doctor's Name:  
 Family Doctor's Phone:  
 Doctor's Address:  
 City:    Zipcode:  
Please add any important information about your child, such as medical or physical conditions (e.g., asthma) in the following area:
SCHOOL INFORMATION
 School Name:  
 School Address:  
 Cross Street(s):  
 School Zipcode:  
 School Class:    Teacher:    Dismissal Time:  
Name anyone other than parents who will be at your building for drop off and their relationship to you or check the following box if dropping off with the doorman is acceptable:
Drop my child off with Doorman
 Greeter #1 Name:   Relationship:  
 Greeter #2 Name:   Relationship:  
 Greeter #3 Name:   Relationship:  
PROGRAM SELECTION
Please indicate the day(s)of the week to enroll: Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Check the Sports you wish to enroll in: Baseball
Soccer
Baseball/Soccer
Lacrosse
Basketball
Volleyball
Golf (additional charge of $100 applies)
Tennis (additional charge of $200 applies)
Flag Football
Floor Hockey
Nursery Sports
Exploring Adventure Program
Sport Fitness and Training
Check the Season(s) you wish to enroll in and note the cost information:
  Fall 2008:
Fall 2008 Sept 8 - Dec 12		 1 Day $1080
2 Day $2052
3 Day $2997
4 Day $3888
5 Day $4590
  Winter 2009:
Winter 2009 Jan 5 - March 13		 1 Day $870
2 Day $1653
3 Day $2414
4 Day $3132
5 Day $3698
  Spring 2009:
Spring 2009 March 30 - June 5		 1 Day $800
2 Day $1520
3 Day $2220
4 Day $2888
5 Day $3400
Corbin's Gear
  Sweatshirt - $25
  Child:  Medium Large
  Adult:   Small   Medium   Large
  Hat - $15
              Youth Adult
  T-Shirt - $10
  Child:  Medium Large
  Adult:  Small Medium Large
 
Lacrosse Gear:
Helmet, gloves and stick required for program
shoulder and arm pads required for team
Helmet - $110:
Stick - $45:
Gloves - $35:  Small  Medium  Large
Shoulder Pads - $35:  Small  Medium  Large
Arm Pads - $25:  Small  Medium  Large
Custom Cost:
( only if you have been told to fill in a custom cost )
If You Have Additional Questions or Comments, Enter Them Below..
SUBMIT APPLICATION
Once you have reviewed the above information,
press the submit button below to continue.
Cancellation Policy and Deposit Schedule:
A non-refundable 20% deposit is due with the application in order to secure a spot.
Payment in full is due one month prior to start of program, 50% of which is refundable
of which is refundable upon cancellation. After the first day of the program
all fees are non-refundable.