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 Vacation Camp
  Corbin's Sports and Adventure Day Camp
School Vacation Day Camp Programs(please check dates below)
Winter Break
December 20 -31: 20 21 22 23 24 27 28 29 30 31


March Spring Break
March 21 - April 1: 21 22 23 24 25 28 29 30 31 1


Total Payment for School Vacation Day Camp Programs:
1 Week ($788) Weeks ($1700)

 # of Days ($180 /Per day)
Summer Day Camp:  Corbinıs Crusaders offers both full and partial weeks to accommodate your busy summer schedules. Select the number of full or partial weeks youıd like to sign up for from the list below.

Full Week Sessions  
 
   
4 Day Week Sessions  
M T W Th F
   
3 Day Week Sessions  
M T W Th F
Please Check off Week(s) Interested:
  
Winter Break Camp:      December 21-24
  December 28-31
 
Spring Break Camp:      March 22-April 5
 
  
Summer Day Camp:      June 14-18 (pre-camp)
  June 21-25 (pre-camp)
  June 28-July 2
  July 6-9 (no camp July 5th)
  July 12-16
  July 19-23
  July 26-30
  August 2-6
  August 9-13

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 )
Coupon Code
( enter valid coupon code here )

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.