2016 Campbell County 4-H Camp Registration

Document technical information

Format pdf
Size 486.5 kB
First found Jul 24, 2016

Document content analisys

Language
English
Type
not defined
Concepts
no text concepts found

Transcript

Virginia Cooperative Extension
Campbell County Extension Office
P.O. Box 67
Rustburg, Virginia 24588-0067
434/332-9538, 592-9538, 283-9538
Fax: 434/332-9647
E-mail: [email protected]
Dear 4-H Campers, Volunteers and Families,
It’s 4-H Camp time! The 2016 4-H Summer Camp will be held July 18-22, 2016. We want to
inform of you of some exciting changes regarding 4-H Camp sign-up. Over the years, we have
had requests for an open registration as opposed to a one day sign-up. This year we are going
to try the open registration. This will allow you to mail or bring by your registration and
payment. Registration will remain open until camp is filled.
So, how is this going to work? We have designated December 1st, 2015 as the day that we will
begin accepting registrations. A deposit of $70 will reserve a camp space; the full fee will
remain the same as last year at $210. Camp spaces will be available based on a first come, first
serve basis as in the past. If people would like to give the gift of camp we will be glad to
provide a card for them to give announcing their gift.
We are working through all of the details and hope to make this process as smooth as possible.
One difference is that camp classes will be chosen later in the process since we do not yet know
what classes will be available. When class forms are sent out, everyone who has reserved a
camp space will have the same opportunity to sign-up for classes.
We hope that this change will make sign-up an easier process for everyone. Please feel free to
contact us if you have any questions or concerns.
Sincerely,
Robbie Morrison
Extension Agent, 4-H Youth Development
Invent the Future
V I R G I N I A
P O L Y T E C H N I C
I N S T I T U T E
A N D
S T A T E
U N I V E R S I T Y
Extension is a joint program of Virginia Tech, Virginia State University, the U.S. Department of Agriculture, and state and local governments.
Virginia Cooperative Extension programs and employment are open to all, regardless of race, color, national origin, sex, religion, age, disability, political beliefs,
sexual orientation, genetic information, marital, family, or veteran status, or any other basis protected by law. An equal opportunity/affirmative action employer.
For additional information, contact the
Campbell County Extension Office:
2016 Campbell County
Phone: 434/332-9538, 434/592-9538 or 434/283-9538
Fax: 434/332-9647
Join Us!
Camper Eligibility:
Campbell County 4-H Camp is open to all youth residents of
Campbell County who are 9-13 years old. If you are not sure if
your child is eligible, please call our office. The following age
limitations apply:
 Campers must be 9 years old on or before September 30,
2016.
 Older campers are eligible as long as they were no older
than 13 years old as of January 1, 2016.
Camp Details:
Come and experience the 2016 Campbell County 4-H Summer
Camp! Spend an exciting week camping at the Holiday Lake 4-H
Educational Center. The 4-H Center is located in the beautiful
Buckingham/Appomattox State Forest. Holiday Lake 4-H
Educational Center is an Accredited Camp certified through the
American Camping Association.
Youth will have the opportunity to experience a variety of camp
classes, afternoon activities, and special evening programs which
are great fun for all. Camp allows young people the opportunity
to develop independence and life skills in a cooperative group
setting.
Campers will depart by bus on Monday, July 18, 2016 at 8:45
a.m. from Rustburg High School and will return at 11:00 a.m. on
July 22, 2016 to the same site.
Email: [email protected]
Website: http://offices.ext.vt.edu/campbell/
Facebook: Campbell County 4-H, VA
Mailing Address:
VCE-Campbell County
P.O. Box 67
Rustburg, VA 24588
Physical Address: Agriculture Building
163 Kabler Lane; Rustburg
If you are a person with a disability and desire any assistive devices,
services or other accommodations to participate in the 2016 4-H
Camp, please contact Robbie Morrison at the Extension Office no
later than two weeks prior to the date assistance is needed. Our
office hours are Monday-Friday, 8 a.m. – 5:00 p.m.
_________________________________
Robbie Morrison
Extension Agent, 4-H Youth
AN EQUAL
OPPORTUNITY/AFFIRMATIVE
ACTION EMPLOYER
A 5 Day Overnight Camp For
For Youth Ages 9-13
Held at
Holiday Lake 4-H Center
July 18-22, 2016
Campbell County 4‐H Summer Camp July 18‐22, 2016 Register for Camp
Lots of exciting classes
to choose from!
Registration for camp will begin on:
December 1st 2015
COST OF CAMP
$210.00 1st Child
$205.00 2nd Child
$200.00 3rd Child*
This covers all programming fees, meals, lodging, t-shirt and
transportation from Rustburg High School.
*Additional children are charged at the same rate as the third child.
PAYMENT SCHEDULE
$70.00 due at Registration
$70.00 payment due by April 8th
$70.00 (balance) due by May 13th
Payment may be made in full at any time.
No refunds will be given after June 3,
2016
PAYMENT OPTIONS
We accept personal checks, money orders and cash in
the exact amount (we do not keep change). We are
NOT able to accept debit or credit cards. Please note
the campers name on all payments.
A Sample of the Classes that MAY be offered.
Advanced Swimming
Beginning Swimming
Archery
Arts & Crafts
Canoeing
Cooking/ Foods
Fishing
GauGau
Leather Crafts
Low Ropes
Nature & Forestry
Riflery
Sports of All Sorts
Theatrical Arts
Woodworking
Additional Class Options For
12-13 Year Old Campers
Climbing Wall
High Ropes
$50.00 FEE on all RETURNED CHECKS
Teen Life / CIT
Kayaking
SCHOLARSHIPS
Partial scholarships are available based on financial
need. Contact the 4-H Office if you are interested in
applying for a scholarship.
and continue until all spaces are filled.
Spaces for camp will be available on a first
come first serve basis.
 Reserve your spot for camp with a $70
deposit.
 Give the gift of camp! We will be glad to
provide a card for you to give announcing
your gift.

There will be
NO CLASS CHANGES
after your Camp Class Form
is turned in.
Choose classes CAREFULLY!
Registrations and deposits may be brought to
our office between 8:00 and 5:00 in the:
Agriculture Building
163 Kabler Lane
Rustburg
Or mailed to :
VCE-Campbell County
PO Box 67
Rustburg, VA 24588
4‐H Camp would not be possible without the help of adult volunteers. There is no cost for an adult volunteer to attend camp, just the completion of camp training. This is a great way to share this experience with your child. IF INTERESTED CONTACT THE EXTENSION OFFICE FOR AN APPLICATION. Campbell County 4-H Summer Camp Registration Form 2016
Name
CIRCLE NAME YOU LIKE TO BE CALLED
Mailing Address
City
Zip Code
Email
Cell Phone #_________________________ Phone (Home if different from Cell)
Date of Birth
Age
Grade
School
Parent/Guardian or sibling in the military? □ No one serving
□ Parent/ Guardian serving □ Sibling serving
□ Active Duty □ National Guard □ Reserves
Branch?
Gender
Hispanic Ethnicity (check one)
Racial Groups (check all that apply)
Residence (check one)
o Female
o Hispanic or Latino
o White
o Farm
o Male
o Not Hispanic or Latino
o Black or African American
o Rural Non –farm or town less than 10,000
o American Indian or Alaskan Native
o Town/City 10,000 to 50,000
o Asian
o Suburbs of cities over 50,000
o Native Hawaiian or Other Pacific Islander
o City over 50,000
The following information will be used by the office to contact you with problems concerning registration, please circle if you
prefer to be contacted at a particular number. When you receive the Health History Form you will be asked to provide a
complete list of emergency contacts.
Mother/ Guardian
Cell Phone
Mother’s place of work
Work Phone
Father/ Guardian
Cell Phone
Father’s place of work
Work Phone
Other numbers
For Office Use Only- Office Staff Will Complete This Section
Balance Due
Initial Payment:
Amount received:
Payment Type: Cash
Date received:
Check #
Money Order #
Balance Due
Second Payment
Amount received:
Payment Type: Cash
Date received:
Check #
Money Order #
Balance Due
Final Payment
Amount received:
Payment Type: Cash
Date received:
Check #
Money Order #

Similar documents

×

Report this document