APPLICATION FOR CORBIN'S CRUSADERS SKI 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
 Greeter #1 Name:   Relationship:  
 Greeter #2 Name:   Relationship:  
 Greeter #3 Name:   Relationship:  
PROGRAM SELECTION
Day Trips: Tuesday, December 22nd $250
Tuesday, December 29th $250
Sunday January 31st $250
Saturday, March 6th $250
Overnight Trip: February 26th - 28th $550
Half-Day Lessons: 1 - $40/hr2 - $80/hr
Full-Day Lesson $65(required for beginners)
Private Group Lesson $75/hr
Equipment Rental: 1 Day $40
2 Days $80
3 Days $120
4 Days $160
Pick Up Locations: East Side - 86 & 3rd Ave
West Side - 86th & Broadway
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:
Payment in full is due upon registration. Refunds are subject to the discretion of Corbin's Crusaders.