Spring Break Camp

Discover the Adventure of Spring Break Camp

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$100 One Time Payment

$25 Payment Plan (Monthly for 4 Months)

JP Media Survey 1

Spring Break Camp

April 3-7, 2023 from 8am-4pm
Student Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian Full Name*

First NameLast Name
Parent E-mail*
example@example.com
Mobile Number*
Phone Number
Work Number
Emergency Contacts (Name and phone Number for all)*
Authorized people to pick up*
Medical Information (anything we would need to know - if none write n/a)*
Acknowledgement, I the undersigned attest that I am legally responsible to give permission to the student named above to participate in the activities of the programs for which they have applied. I give permission to Sturgeon City of Jacksonville, NC and its partners to release and allow photography and identification (including first name, age and school) of my minor child for publicity, news coverage, promotional presentations and web presentations of its programs as needed. I understand that those associated with the camp will not share the birth date or other personal information except to medical personnel or as required by law. I give permission to camp staff to take reasonable actions should my child be injured or need treatment while making efforts to contact me or the persons named above for further guidance. I accept the responsibility of retrieving my child at any hour and at any place if my child becomes a discipline problem or is disruptive to the program or other students.*

Yes
Acknowledgement, I understand that camp must be paid for in full in order to secure my child's spot in the class. Full payment is due by close of business Monday, a week before camp starts. Non- payment will result in the camper being removed from the roster and their space becoming available to new registrants.50% of the camp payment will be fortified if cancelled less than the Tuesday before the start of camp. Refunds will not be given if your child does not attend the camp registered for. Refunds will not be given to those who cancel less than 48 hours before the start of the camp week. Refund requests must be made in writing to programming@sturgeoncity.org and must be received by the close of business the Monday before the start of camp. All past due balances must be paid in full before your registration form is accepted for the current year. Registrations for camp will not be accepted or processed on the weekend before the camp week starts. Hours of camp are 8:00am-4:00pm. Drop off will not be accepted before 7:50am. Pickup can be anytime before or on 4:00pm promptly.*

Yes

My Products

Spring Break Camp - 1 PaymentPay for the entire week of camp

$100.00

Total

$0.00

Credit Card

Should be Empty:

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Ride With Passion

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