SPN Summer Camp 2021

Thank you for choosing SPN Summer Camp

WELCOME TO SPNSC - 2021

SPN Summer Camp Prices for 2021

One Child: $90
Two Children: $160
Three or More Children: $225

***Prices DO NOT include extended care***

Prices above are per week. Each class will run from 08:45am - 12:00pm Monday - Friday.

All-Day Program (Camp + Before & AfterCare): $2,000

***If you choose the All-Day Program you are paying for 9-Weeks***

BeforeCare begins at 6:30am and AfterCare ends at 6:00pm

CONTACT INFORMATION

LAST NAME: * 🛈

PRIMARY PHONE NUMBER: * 🛈

MOTHER'S FIRST NAME * 🛈

MOTHER'S WORK PHONE: 🛈

MOTHER'S CELL PHONE: 🛈

FATHER'S FIRST NAME: 🛈

FATHERS WORK PHONE: 🛈

FATHER'S CELL PHONE: 🛈

PRIMARY EMAIL ADDRESS: * 🛈

ENTER AGAIN FOR CONFIRMATION * 🛈

SECONDARY EMAIL ADDRESS: 🛈

STREET ADDRESS: * 🛈

CITY, STATE, AND ZIP CODE *

Home Parish: * 🛈

STUDENT REGISTRATION

SUMMER PROGRAM CLASS TIMES
A parent/guardian will be required to check your child into the program between 08:30am and 08:45am and check them out between noon and 12:15pm. Before care opens at 6:30am and after care closes at 6:00pm. BeforeCare sign-up will be available every morning before classes begin.

HOW MANY CHILDREN ARE YOU GOING TO REGISTER?
(Children must be part of your immediate family in order to be registered together to qualify for the multi-child discount. If you have more than six children to register, please contact us at summercamp@st.philip-neri.org) *

Choose an option for your family *

Camp Only

All-Day Program (includes Before & AfterCare for 9 weeks)

Before Care and Camp (choose particular weeks below)

How many weeks will you be using our BeforeCare services? (only answer if you have not chosen All-Day Program) (Place zero if you will not be using our extended care services) *

CAMP INFORMATION CHILD #1

STUDENTS FIRST NAME: * 🛈

AGE: * 🛈

GENDER: *

Formatted Text

WEEK 1 (June 14 - June 18) 🛈

WEEK 2 (June 21 - June 25) 🛈

WEEK 3 (June 28 - July 2) 🛈

WEEK 4 (July 5 - July 9) 🛈

WEEK 5 (July 12 - July 16) 🛈

WEEK 6 (July 19 - July 23) 🛈

WEEK 7 (July 26 - July 30) 🛈

WEEK 8 (August 2 - August 6) 🛈

WEEK 9 (August 9 - August 13) 🛈

Vacation Bible Camp (for all campers)

CAMP INFORMATION CHILD #2

STUDENTS FIRST NAME: * 🛈

AGE: * 🛈

GENDER: *

WEEK 1 (June 14 - June 18) 🛈

WEEK 2 (June 21 - June 25) 🛈

WEEK 3 (June 28 - July 2) 🛈

WEEK 4 (July 5 - July 9) 🛈

WEEK 5 (July 12 - July 16) 🛈

WEEK 6 (July 19 - July 23) 🛈

WEEK 7 (July 26 - July 30) 🛈

WEEK 8 (August 2 - August 6) 🛈

WEEK 9 (August 9 - August 13) 🛈

Vacation Bible Camp (for all campers)

CAMP INFORMATION CHILD #3

STUDENTS FIRST NAME: * 🛈

AGE: * 🛈

GENDER: *

WEEK 1 (June 14 - June 18) 🛈

WEEK 2 (June 21 - June 25) 🛈

WEEK 3 (June 28 - July 2) 🛈

WEEK 4 (July 5 - July 9) 🛈

WEEK 5 (July 12 - July 16) 🛈

WEEK 6 (July 19 - July 23) 🛈

WEEK 7 (July 26 - July 30) 🛈

WEEK 8 (August 2 - August 6) 🛈

WEEK 9 (August 9 - August 13) 🛈

Vacation Bible Camp (for all campers)

MEDICAL INFORMATION CHILD #1

Does this child reside in the state of Maryland? [If NO, Please enter the U.S. state, territory or the District of Columbia (if neither, then country) in which this child resides.] *

YES

NO (enter U.S. state, territory, D.C. or country) NO (enter U.S. state, territory, D.C. or country)

If child does NOT reside in a U.S. state or territory, you must complete

Form DHMH-896 (record of vaccination or immunity) and submit

it to SPNSC prior to the first date the child attends camp.

Is this child exempt from any immunizations? *

NO

YES (Please list them:) YES (Please list them:)

Are there any health problems, including physical, psychiatric, or behavioral problems, of which we need to be aware? * 🛈

NO

YES (Please list below. Note that, prior to your first day of camp, you must present a plan of action signed by your doctor for ANYTHING listed) YES (Please list below. Note that, prior to your first day of camp, you must present a plan of action signed by your doctor for ANYTHING listed)

Food Allergies? (Please list all food allergies seperated by commas) 🛈

Are there any medications, dietary restrictions or special needs of which we should be aware to ensure that your child's camp experience is positive? * 🛈

NO

YES (please list:) YES (please list:)

Are there other Special needs of which we should be aware?: * 🛈

NO

YES (Please explain) YES (Please explain)

Please Note: If you need to send sunscreen or any type of medication to

camp with your child, please review the information and required forms on

our Camper's Health & Safety

MEDICAL INFORMATION CHILD #2

Does this child reside in the state of Maryland? [If NO, Please enter the U.S. state, territory or the District of Columbia (if neither, then country) in which this child resides.] *

YES

NO (enter U.S. state, territory, D.C. or country) NO (enter U.S. state, territory, D.C. or country)

If child does NOT reside in a U.S. state or territory, you must complete

Form DHMH-896 (record of vaccination or immunity) and submit

it to SPNSC prior to the first date the child attends camp.

Is this child exempt from any immunizations? *

NO

YES (Please list them:) YES (Please list them:)

Are there any health problems, including physical, psychiatric, or behavioral problems, of which we need to be aware? * 🛈

NO

YES (Please list below. Note that, prior to your first day of camp, you must present a plan of action signed by your doctor for ANYTHING listed) YES (Please list below. Note that, prior to your first day of camp, you must present a plan of action signed by your doctor for ANYTHING listed)

Food Allergies? (Please list all food allergies seperated by commas) 🛈

Are there any medications, dietary restrictions or special needs of which we should be aware to ensure that your child's camp experience is positive? * 🛈

NO

YES (please list:) YES (please list:)

Are there other Special needs of which we should be aware?: * 🛈

NO

YES (Please explain) YES (Please explain)

Please Note: If you need to send sunscreen or any type of medication to

camp with your child, please review the information and required forms on

our Camper's Health & Safety

MEDICAL INFORMATION CHILD #3

Does this child reside in the state of Maryland? [If NO, Please enter the U.S. state, territory or the District of Columbia (if neither, then country) in which this child resides.] *

YES

NO (enter U.S. state, territory, D.C. or country) NO (enter U.S. state, territory, D.C. or country)

If child does NOT reside in a U.S. state or territory, you must complete

Form DHMH-896 (record of vaccination or immunity) and submit

it to SPNSC prior to the first date the child attends camp.

Is this child exempt from any immunizations? *

NO

YES (Please list them:) YES (Please list them:)

Are there any health problems, including physical, psychiatric, or behavioral problems, of which we need to be aware? * 🛈

NO

YES (Please list below. Note that, prior to your first day of camp, you must present a plan of action signed by your doctor for ANYTHING listed) YES (Please list below. Note that, prior to your first day of camp, you must present a plan of action signed by your doctor for ANYTHING listed)

Food Allergies? (Please list all food allergies seperated by commas) 🛈

Are there any medications, dietary restrictions or special needs of which we should be aware to ensure that your child's camp experience is positive? * 🛈

NO

YES (please list:) YES (please list:)

Are there other Special needs of which we should be aware?: * 🛈

NO

YES (Please explain) YES (Please explain)

Please Note: If you need to send sunscreen or any type of medication to

camp with your child, please review the information and required forms on

our Camper's Health & Safety

EMERGENCY INFORMATION AND LIABILITY WAIVER

Emergency Contact Name (Other than parent) * 🛈

Relationship to the student: 🛈

Phone Number: * 🛈

Child(ren)'s Physician: * 🛈

Phone Number: * 🛈

I give my child(ren) permission to participate in all activities and programs during St. Philip Neri Summer Camp ("SPNSC"). As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor(s). I agree on behalf of myself, my child(ren) named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Philip Neri Parish and SPNSC, their employees, officers, directors and agents, and the Archdiocese of Baltimore, chaperones, or representatives associated with SPNSC (collectively referred to herein as the "Church") from any liability arising from or in connection with my child(ren) attending SPNSC or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the Church for reasonable attorney's fees and expenses arising in connection therewith.

I understand and agree that photographs and/or videotapes of participants of St. Philip Neri's Summer Camp may be used in publications, websites or other materials produced from time to time by the Church. Participants would not be identified, however, without specific written consent. I also understand that the Church has no control over the use of photographs or film taken by media that may be covering the Program.

Your agreement to the above is required in order to register your child(ren) in St. Philip Neri's Summer Camp. Please indicate your agreement below by checking the box and typing your name in the space provided. * 🛈

I AGREE I AGREE

ADMINISTRATION INFORMATION

Please list the names of any adults that are authorized to drop off or pick up your child from our Summer Program.

Please enter the number of children you have registered for the All Day Program:
$2,000 per child
or
Please enter the number of weeks you have only one child registered for Camp Only, the number of weeks you have two children registered for Camp Only, and the number of weeks you have registered three or more children for Camp Only.
1 child: $90 per week
2 children: $160 per week
3 or more children: $225 per week

EXAMPLES:
A) You have three children and one of your children is registered in week 3, the
other two are registered in weeks 6 & 7, and all three are registered for week 8. You
ENTER 1 for Number of Weeks Only One Child is Registered (for week 3); ENTER 2 for
Number of Weeks Two Children are Registered (for weeks 6 & 7); and ENTER 1 for
Number of Weeks Three or More Children are Registered (for week 8).

B) You have three children registered in week 3,5, and 6. You ENTER 3 in
Number of Weeks Three or More Children are Registered (for
weeks 3, 5 and 6).

	Number of Children All Day Program
	Number of Weeks One Child Camp Only
	Number of Weeks Two Children Camp Only
	Number of Weeks Three or More Children Camp Only

For your current total, please click the CALCULATE button below.

The total that shows below is for our SPN Summer Camp registration, this DOES NOT include cost for before or aftercare. Extend care fees are due 7 days prior to use.

Payment is due at the time of registration to reserve registration.

Those paying by check have five business days from the time of registration to submit payment. If additional time is needed, please contact our camp coordinators (summercamp@st.philip-neri.org).

$0.00

1 Child	2 Children	3 Children	4 Children
5 Children	6 Children

Capes & Comics	Happy Holidays
Dance & Theatre	Treasure/Scavenger Hunt
Junior Super Heroes (children ages 4-5)

Gross & Fun Science	Olympic Games
Camp Camp	Jewelry Making
Jr. Scientist (children ages 4-5)

Crazy Games	Boys Being Boys (boys only)
Spa Science (girls only)	Air & Space
Disney Little's Camp (children ages 4-5)

Dance & Theatre	Treasure/Scavenger Hunt
Happy Holidays	Capes & Comics
Happy Holidays (children ages 4-5)