Child's Name: Boy: Girl: Date of Birth (mm/dd/yy): Camper's USCF Rating: Parent Name: Home Phone# Work Phone# Email Address: Address: City: State: Zip Code: Fee Schedule: $110.00 - Due with Enrollment Chess Camp times are 9am - 12pm June 21 - June 25, 2010 June 28 - July 02, 2010 July 05 – July 09, 2010 July 12 - July 16, 2010 July 19 - July 23, 2010 July 26 - July 30, 2010 Aug. 02 - Aug. 06, 2010 Aug. 9 - Aug. 13, 2010 Aug. 16 - Aug. 20, 2010 Aug. 23 - Aug. 27, 2010 Afternoon Camp: None Natural History Museum Fleet Science Center Museum of Man Model Railroad Museum Spanish Village Air & Space Museum Japanese Garden Museum of Photographic Arts San Diego Youth Ballet
Purchase a T-Shirt: (T-Shirts will be waiting for you at the Camp) Size of First T-Shirt (Additional $15): Select Small Medium Large X Large XX Large Size of Second T-Shirt (Additional $15): Select Small Medium Large X Large XX Large Payment Method: Visa Mastercard Discover Credit card number: Exp (mm/yy): Three Digit Code on the Signature Panel on the back of the card: NAME (as it appears on credit card): I approve this application and certify the applicant(s) capable of such an experience. I grant permission for the applicant to participate in all camp activities understanding that competent leadership will be provided. In case of accident the camp is authorized to secure emergency medical treatment. The camp is not responsible for lost, stolen or damaged personal articles. I authorize the camp to have and use photographs, slides and video tapes of the person(s) names on this application.
