APPLICATION FOR CORBIN'S CRUSADERS SPORTS CAMP
For Sports Club Information Click Here


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
Check the Sports Camp you wish to enroll in:
  School Spring Vacation Camp
  Corbin's Mixed Sports and Adventure Day Camp
  Lacrosse Specialty Camp
School Vacation Day Camp Programs(please check dates below)
Winter Break
December: 15 16 17 18 19


March Spring Break
March: 16 17 18 19 20 23 24 25 26 27


Total Payment for School Vacation Day Camp Programs:
A Week ($750)

 # of Days ($170 /Per day)
Full Summer Day Camp:
9 Week Session
(June 15 - August 14)		 Cost $6200
8 Week Session Cost $5600
7 Week Session Cost $4900
6 Week Session Cost $4300
5 Week Session Cost $3600
4 Week Session Cost $2950
3 Week Session Cost $2200
2 Week Session Cost $1500
1 Week Session Cost $750
4 Day Week Session Cost $620
3 Day Week Session Cost $510
Please Check off Week(s) interested

 Winter Break Camp:     
December 15-19    
Spring Break Camp:     
March 16-20    
March 23-27    

 Summer Day Camp:     
June 15-19    
June 22-26    
June 29-July3    
July 6-10    
July 13-17    
July 20-24    
July 27–31    
August 3-7    
August 10-14    
                   

Additional Notes about Weeks Attending:
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
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:
Non-refundable $200 deposit due per week with application. Remaining balance and all medical
forms are due by May 1st. After the first day of Camp, all fees are non-refundable.