2018 A.C.T. SUMMER CAMP APPLICATION camp app final.pdfPaper Crafts: 3D,Scrapbooking,Origami Wire & Wood ... Session 4 Week 8 8/13-8/17 $40 $50 $80 60% of fee CAMP PROGRAM HOURS: 9:30am

SESSION 3 AUGUST SPECIALTY: AUGUST 6th-AUGUST 10TH

Art Group: (Must be 5.9 to 7.8 years old as of September 1st)

Sport Group: (Must be over 5.9 to 7.8 years old as of September 1st )

Specialist Courses (Must be over 7.9 to 13.9 years old as of September 1st ) Check four desired courses on page 2 for each session.

SESSION 4 AUGUST ADVENTURE: AUGUST 13H -AUGUST 17TH

Adventure Groups (Must be 4.5 to 11.9 yrs. old as of September 1st)

EXTENDED DAY PROGRAM (OPTIONAL) Sunrise drop-off (8-9:15am): $40/wk. (Select weeks on page 3 and calculate )

Evening pick-up (4:10-6:15pm): $50/wk. (Select weeks on page 3 and calculate)

DISCOUNTS: ONLY ONE DISCOUNT MAY APPLY*10% fee reduction of session tuition applied on sibling with lower tuition.$90 fee reduction for eight week enrollment at time of registration.

MISSION FEE: Families enrolled between June 18, 2018–June 18, 2019 must pay a one-time family mission fee. This fee is used for mission driven activities such as community events, financial aid to families, emergency support to children or operational support.

Tuition Registration fee included

Balancedue April. 1

$2,585 $440 $ 2,145

$995 $440 $555

2

$ 490 $200 $290

$420 $200 $220

Fee/week # of Amount

$40

$50

$35

$-

$-

PLEASE INDICATE TOTAL PAYMENT SUBMITTED WITH THIS FORM

$

Make checks payable to: “Summer A.C.T. 2018”

1047 Amsterdam Avenue 212.316.7530 www.actprograms.org

CAMP PROGRAM HOURS: 9:30am - 4:00pm

Credit card processing fee per transaction : 3 %

$

$

$

$$

Please note amount enclosed.

2018 A.C.T. SUMMER CAMP APPLICATION

SESSION 1 JULY THEME: JUNE 25TH - JULY 27TH (5 WEEKS)D I V I S I O N: A G E R A N G EYoung Preps (Must be 3.5-5.8 years old as of September 1st . Priority spaces for siblings in camp, returning campers and ACT preschoolers. Campers must be potty trained. Preps (Must be 5-9 to 7.8 years old as of September 1st)Voyagers (Must be 7.9 to 10.8 years old as of September 1st)Pioneers (Must be 10.9 to 13.9 years old as of September 1st)

Young Preps (Must be 3.5-5.8 years old as of September 1st. (2 wk. minimum enrollment for August session ) Priority spaces for siblings in camp, returning campers and ACT preschoolers. Campers must be potty trained.

Art Group: (Must be 5.9 to 7.8 years old as of September 1st)

Sport Group: (Must be over 5.9 to 7.8 years old as of September 1st )

Specialist Courses (Must be over 7.9 to 13.9 years old as of September 1st ) Check four desired courses on page 2 for each session.

SESSION 2 AUGUST SPECIALTY: JULY 30TH- AUGUST 3RD

D I V I S I O N: A G E R A N G E

$

CAMPER NAME: DATE OF BIRTH: GENDER:AGE AS OF SEPT 1,2018 : _______ SCHOOL ATTENDING IN SEPTEMBER:__________________________________GRADE IN SEPTEMBER:____

CAMPER INFO

$490 $200 $290$



Please check division section on the left.



2 weeks only


Balancedue April. 1

Balancedue April. 1

Balancedue April. 1

Registration fee included



Tuition

Tuition

Tuition

Balancedue April. 1


Tuition

$

$2,495 $440 $ 2,055

Balancedue April. 1


Tuition


$


CAMP PROGRAM HOURS: 9:30am - 4:00pm

SPECIALIST COURSES (Must be over 7.9 to 13.9 years old as of September 1st)Select four courses from the categories below. Each student is schedule for three courses

STUDIO ARTSTUDIO ART focus on learning specific techniques that will enhance the outcome of projects using a variety of materials based on known artists.

Painting & Collaging Printing & SketchingMosaic & Sculpting Slow motion Clay

GAMES

GAMES is a time to enjoy playingwith friends while staying active.

Gaga & 9 squaresPaddle Games & Gym GamesBall and Laser Tag games

SPORTS CLINICS

CLINICS are designed to help you be more competitive in traditional sports by knowing rules, strategy and skills to succeed.Softball/wiffleBall Basketball/ Touch Football SoccerFloor / Hockey

2018 Summer Camp Application: page 2

A.C.T. AUGUST COURSE SELECTION FORM

SPECIALIST COURSES (Must be over 7.9 to 13.9 years old as of September 1st)Select four courses from the categories below. Each student is schedule for three courses

SESSION 2: AUGUST SPECIALTY: JULY 30-AUGUST 3 2018 (1 WEEK)

SESSION 3: AUGUST SPECIALTY: AUGUST 6-AUGUST 10 2018 (1 WEEK)

Select four

CAMPER NAME: DATE OF BIRTH:

Select fourDO-IT-YOURSELF

DO-IT-YOURSELF ARTS courses focus on projects students learn to create reflecting their interest and replicate at home.Puppetry & Paper MacheTie dying & Jewelry Paper Craft:3D,Scrapbooking,OrigamiWire & Wood

STUDIO ARTSTUDIO ART focus on learning specific techniques that will enhance the outcome of projects using a variety of materials based on known artists.

Painting & Collaging Printing & SketchingMosaic & Sculpting Slow motion Clay Animation

GAMES

GAMES is a time to enjoy playingwith friends while staying active.

Gaga & 9 squaresPaddle Games & Gym GamesBall and Laser Tag games

SPORTS CLINICS are designed to help you be more competitive in traditional sports by knowing rules, strategy and skills to succeed.

Softball / wiffleBall Basketball / Touch Football SoccerFloor / Hockey

STAGE

Let the performer in you shine in front or behinf the scene . Learn lyrics and dances to favorite tunes. Learn new tricks or perform in front of friends.Musical Theatre Karaoke & Wii DanceCommercials and auditions

DO-IT-YOURSELF ARTS courses focus on projects students learn to create reflecting their interest and replicate at home.Puppetry & Paper MacheTie dying & Jewelry Paper Crafts: 3D,Scrapbooking,OrigamiWire & Wood

DO-IT-YOURSELF

Explore the campus and surrounding parks to identify natural objects, experiment and discover new areas.

Joggers, Hikers, Scotterist (only for 4th grade and up. Must have scotter and safety equiment.)

Bugs, Rocks and Herbs

EXPLORATIONS

Explore the campus and surrounding parks to identify natural objects, experiment and discover new areas.

Joggers, Hikers, Scotterist (only for 4th grade and up. Must have scotter and safety equiment.)

Bugs, Rocks and Herbs

EXPLORATIONS

Let the performer in you shine in front or behinf the scene . Learn lyrics and dances to favorite tunes. Learn new tricks or perform in front of friends.Musical Theatre Karaoke & Wii DanceCommercials and auditions

STAGE

Dates Morning: 8:00- 9:15 am

Afternoon 4:10– 6:15pm Both AM & PM Second child fee

Session 1 Week 1 6/25-6/29 $40 $50 $80 60% of fee

Session 1 Week 2 7/02-7/6 $40 $50 Closed all day 7/4/18 $80 60% of fee



Session 1 Week 5 7/23-7/27 $40 $50 Closed at 4pm on Friday 7/27/18 $80 60% of fee


Session 3 Week 7 8/06-8/10 $40 $50 Closed at 4pm on Friday 8/10/18 $80 60% of fee


CAMP PROGRAM HOURS: 9:30am - 4:00pm2018 Summer Camp Application: page 3

2 0 1 8 A . C .T. C A M P F A M I LY I N F O R M AT I O N

PARENT 1 NAME:Occupation:Work Number:Home Address:Work Day Cell number:Home Phone:List e-mail you prefer for newsletters, updates and invoiceWork E-mail:Rewrite E-mailHome e-mail:Rewrite E-mail address to confirm:

PARENT 1 INFOPARENT 1 NAME:Occupation:Work Number:Home Address:Work Day Cell number:Home Phone:List e-mail you prefer for newsletters, updates and invoiceWork E-mail:Rewrite E-mail:Home e-mail:Rewrite E-mail address to confirm:

PARENT 2 INFO

EXTENDED DAY PROGRAM OPTIONS: Payable with this form or one week in advance.

Please check sessions that apply. Carefully complete this form. Note that errors and omissions of information may cause inappropriate placement of campers that may not be remedied. All families must indicate the program camper is interested in enrolling. Please note age restrictions. Families with children under 6 years of age must be prepared to present proof of child’s age.

CAMPERS PAIRING REQUESTRequests must be submitted with this registration. We emphasis the development of life skills through team building and group activities. Campers are expected to make new friends and share common goals. We do not aim to keep children from the same school together. Enrollment cannot be contingent on group placement with a particular friend. Note that campers are grouped according to age. When possible, appropriate and when requested in a timly manner, we will try to meet the camper pairing request.Please list complete name (first and last) of only two friends.Name One Name Two

1047 Amsterdam Avenue New York, N.Y. 10025 212.316.7530 WWW.ACTPROGRAMS.ORG

EXTENDED DAY OPTIONS

Extended day fees can not be refunded,prorated based on use or exchanged once enrolled. One week advance registration is required once camp opens. Space is limited so enroll early.

CAMPER NAME: DATE OF BIRTH:

2018 Summer Camp Application: page 4

a) The registration fee as shown on page 1 of this form is per session for each camper must be included to determine availability of space and is non-refundable after 2/1/18. This fee is applied towards camp tuition. In the event space is not available, the registration fee will be returned in full.b) The registration fee and tuition fee may be charged to a Visa or Master charge debit/credit card with a 3% processig fee.c) Full payment for all sessions must be received no later than April 1, 2018 to remain enrolled. A.C.T. reserves the right to accept only a certified check or money order for payments made after April 1, 2018. A.C.T. will send an E-mail to confirm balance due.d) OTHER FEES: Administrative fee: $60 will be imposed for registration changes after application is processed. Returned bank check fee: $30.00 or whatever the bank charges. Extended Day Sunrise session: $40.00/wk. (8:00 a.m.-9:10 a.m.) payable in advance or by Wednesday prior of each week. Extended Day Evening session: $50.00/wk. (4:00 p.m.-6:00 p.m.) week payable in advance by Wednesday prior of each week. Water Park trip: $20.00 Overnight Camping fee: $55.00 Late pick-up fee: $10.00/fifteen minutes or any fraction thereof for children picked up after 4:00 and 6:15 p.m. Credit card processing fee 3% per transaction even if card is declined or reversed.

2 0 1 8 A.C.T. S U M M E R C A M P STIPULATIONS

DISCOUNTSDiscounts may not be combined, only one may apply.a) Discounts are only applied at time of initial registration only. •A10%feereductionintuitionforsiblingsinsamesessionwillbegrantedtosiblingwithlowertuition. •$90feereductionforeightweekenrollmentiscreditedonthelastsession(Notapplicabletofinancialaidcandidates).•$25non-refundableCanteencredittothefamilythatrecruitedanewlyenrolledfamilytocamp,verifiedpriortocampopening.

REFUND POLICYa) Refund, transfer, or credit of registration fees or tuition will not be granted after February 1, 2018.b) A family who applies for financial aid and does not receive an A.C.T. grant will get a full refund of registration fee.

PROGRAM CHANGES AND EXPULSIONa) A.C.T. reserves the right to change, cancel or postpone activities without notice.b) A.C.T. reserves the right to remove a camper from any of its programs for reasons which administrators, in consultation with the Executive Director, deem good and sufficient.c) Physical assault or life threatening behavior by a child in camp is not tolerated and are grounds for immediate expulsion.

REQUIRED FORMSa) Once registration form is received, space availability is confirmed in writing by e-mail within 2-3 work days of receipt.b) All campers must have medical form with current immunization records, emergency treatment and trip permission forms, and pick-up authorization list prior to participation in activities. Other forms are required.c) An incomplete or inaccurate registration form may cause delay in group assignment. Inaccurate information may result in inappropriate group placement. Errors and omissions on forms must be brought to the attention of office staff immediately.d) Birth certificate may be required as proof of age for group placements.

I, (please print) , have read and agree to the terms and conditions listed above on this form. My child (camper’s name) has permission to go on any trip organized and supervised by A.C.T. programs. If I cannot be reached and my child requires emergency treatment, either because of illness or accident, I hereby authorize the A.C.T. Programs to call in a physician or to take my child to a hospital or physicians office for this purpose. Photographs and videos in which my child appears may be used by A.C.T. Programs known as the Cathedral Church of St. John the Divine for publicity and public relations purposes.

SIGNATURE OF PARENT/GUARDIAN DATE / /

PAYMENT AND FEE STIPULATIONS

Documents

2018 A.C.T. SUMMER CAMP APPLICATION camp app final.pdfPaper Crafts: 3D,Scrapbooking,Origami Wire & Wood ... Session 4 Week 8 8/13-8/17 $40 $50 $80 60% of fee CAMP PROGRAM HOURS: 9:30am