2004 SUMMER YOUTH PROGRAM REGISTRATION INFORMATION

Brandywine Valley Association members registration will be accepted as soon as you are in receipt of the camp brochure. If you are not a member and would like to join, please include the necessary information below. To ensure your child’s space at camp, please fill out and mail the form with the registration fee. Registration is on a first-come, first-served basis for those who are paid in full. RESERVATIONS WILL BE ACCEPTED BY MAIL AND WALK-INS ONLY, PLEASE NO PHONE CALLS. If program is cancelled or full, participants will be fully refunded. Visit our website at www.brandywinewatershed.org to check on the status of camp programs. Cancellation on the part of the participant must be made at least TWO WEEKS PRIOR to the start of the program for a refund. A camper cannot repeat the same session in one summer. Confirmations will be sent to participants approximately one week prior to the individual programs outlining the week’s activities as well as other items to bring. If a program is full, you will be notified by phone immediately. All programs will take place regardless of weather unless noted. To ensure a safe and fun program, in which children are of the same developmental level, we strictly enforce an age requirement. Due to the nature of activities in our programs, we are only able to register campers with special needs on a case by case basis. Please call the office at 610-793-1090 for more information. One t-shirt and water bottle per camper during the summer, even if attending for more than one week.

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BVA PROGRAM AND MEMBERSHIP REGISTRATION FORM
Membership categories (please check appropriate category):
______ Family-$40        ______Conservationist-$50          _______Brandywine Benefactor-$100

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Parent’s Name_________________________________________________________________

Address______________________________________________________________________

City_________________State_____Zip_______Phone(h)(_____)______________(w)(_____)_______________

Emergency Number(_____)___________________ Cell Number(_____)___________________

What school does the child attend?_____________________

_____I give my permission for camp photographs of my child(ren) to be taken for publicity purposes.

_____I do not give my permission for camp photographs of my child(ren) to be taken for publicity purposes.

Participant’s Name_______________________ Age (as of first day of program)______
Birthdate ___/___/___
Program Title_____________________________
Dates of Program_____________________Fee_______
T-Shirt Size:(circle one) Child: Small (6-8) Med. (10-12) Lg. (14-16) Adult: Med, Lg., X-Lg.

Participant’s Name_______________________ Age (as of first day of program)______
Birthdate ___/___/___
Program Title_____________________________
Dates of Program_____________________Fee_______
T-Shirt Size:(circle one) Child: Small (6-8) Med. (10-12) Lg. (14-16) Adult: Med, Lg., X-Lg.

Participant’s Name_______________________ Age (as of first day of program)______
Birthdate ___/___/___
Program Title_____________________________
Dates of Program_____________________Fee_______
T-Shirt Size:(circle one) Child: Small (6-8) Med. (10-12) Lg. (14-16) Adult: Med, Lg., X-Lg.