2010 Camp Trinity Registration Form

Welcome to Camp Trinity 2010. We are happy to have you join us on this fantastic weekend for the Holy Trinity Parish Community!

Please note that before you can submit this registration form, you will need to complete the payment information. This means that you must either enter the check number(s) that you will use for payment, or the confirmation code that you receive from online payment. The form will prompt you before the end, letting you know when to do this, and you can open a separate window or tab to pay online when you get to that step, if that is your preferred mode of payment. If you leave this form before clicking on the "Submit" button, you will lose the data you have entered.

All fields marked with an asterisk "*" are required.

Family name(s)*:

REGISTRATION AND HOUSING INFORMATION

First time campers?*:

Yes

Address*:

Home Phone*:

Office Phone:

Cell Phone(s):

Please list your primary email address so that we can communicate payment information, last-minute information and other important details. We will also send volunteer information to the individual email address(es) that you list later in the form under "Volunteer Assignments".

Primary Email Address*:

Additional email addresses:

Please add any additional email addresses where you would like to receive Camp Trinity information.

Please list all names as you want them to appear on your name tags; please include last names.

Name tags*:

CHILDREN AND YOUTH
So that we can organize activities and supervision for children of all ages, please provide the following information. Grade is as of the 2010-2011 school year; age is as of September 24.

For each child, please list:
1) Child's name
2) Age
3) Grade
4) Sex
5) Birthdate
6) School

Children and Youth:

Special Housing Requests (Note: highchairs are available in the dining room):

List the name of the teen:

I would like to room with...

Roommate request:

I would like a room near...

Room near:

Are you an adult coming alone willing to share a room with an adult of same sex?

Seeking a roommate:

Yes

2010 REGISTRATION FEES:
Adult (21 and older) - (Early bird; registered by July 18)- $150
Adult (Regular rate applies July 19-August 15) - $155
Adult (Cost after August 15) - $165
Teen (13-20) - $100 (At any time)
Pre-teen (8-12) - $90 (At any time)
Child (3-7) - $70 (At any time)
Under 3 - $25 (At any time)

Donations to the Camp Trinity Scholarship Fund help, not only with camper scholarships, but also help defray the costs of the weekend for all, by paying for program expenses not covered by registration fees.

Note that to ease the burden on larger families, the total is capped at $475 when families register by August 15, and capped at $500 after August 15.

Total Number of People Attending & Payment Due

# of Adults*: (21 and older)

Total Payment Due for Adults*: $

# of Teens: (13-20 years)

Total Payment Due for Teens: $

# of Pre-teens: (8-12 years)

Total Payment Due for Pre-teens: $

# of Children: (3-7 years)

Total Payment Due for Children: $

# of Children Under 3: (Under 3)

Total Payment Due for Under 3: $

Subtotal Due*: $

If requesting a scholarship, indicate amount of request: $

Donation to Camp Trinity Scholarship Fund: $

TOTAL Due*: $

After paying the deposit, 50% of the balance is due by July 1 and the remaining 50% is due by August 15.

Checks should be made payable to "Camp Trinity" and mailed to:
Cathy Quinn
310 Little Falls Street
Falls Church, VA 22046

PAYMENT*:

I/we are paying by check I/we are paying online I/we are requesting a scholarship

Payment can be made by check (payable to Camp Trinity) or online using Holy Trinity's giving program. Online payments are preferred. Scholarships and deferred payments are also available. For more information about these opitons, please contact Paul & Cathy Quinn (703.532.8073 or cathy.quinn@verizon.net) or Father Horak (mhorak@holytrinitydc.org or 202.337.2840). In order for your registration to be processed, this section must be filled out completely and payment arrangements made.
REFUNDS:
- A nonrefundable deposit of $20/person, capped at $50/family, is included in the registration fee.
- If written cancellation is received between August 16 and September 5, half of the registration payment is refunded (less the deposit).
- No refunds are given after September 5.

If paying by check, list the check # for nonrefundable deposit ($20/person; capped at $50/family): #

List the amount of the check (nonrefundable deposit): $

If paying by check, list the check # for the first payment (50% of remaining amount) dated July 1: #

List the amount of the check (first payment of 50%): $

If paying by check, list the check # for the final payment (balance) dated August 15: #

List the amount of the check (final payment - balance): $

Or if paying the total amount now by check, list the check #: #

List the amount of the check (for the total): $

If you prefer to pay online, please click here to pay now. Then click on "Make a Donation" and then be sure to select "Holy Trinity Parish" under Organization, and to select "Camp Trinity" under "Donation Type.

If paying online, record the date of payment (Month/Day/Year):

If paying online, record the Confirmation number:

VOLUNTEER ASSIGNMENT - Adult #1 Name*:

Each ADULT is expected to volunteer for at least one task or one hour during hte weekend (see Frequently Asked Questions for a description.) If you know you will not be available for a particular time (eg., Friday night), please indicate that below. Parents with children at Camp Trinity will be assigned to a children's program volunteer slot. If no slots are available, we will assin you to your next volunteer choice.

Adult #1 Email*:

Adult #1 Home Phone:

Adult #1 Work Phone:

Adult #1 will be unavailable the following times:

Adult #2 Name:

If you do not have a second adult attending, skip this section.

Adult #2 Email:

Adult #2 Home Phone:

Adult #2 Work Phone:

Adult #2 will be unavailable the following times:

Adult #3 Name:

If you do not have a third adult attending, skip this section.

Adult #3 Email:

Adult #3 Home Phone:

Adult #3 Work Phone:

Adult #3 will be unavailable the following times:

AUTHORIZATION TO PUBLISH PHOTOGRAPHS
Please fill out and sign (by typing your name and date) the appropriate statement to either give or decline permission to use pictures of you and/or of your children on the church website, bulletin and/or other church publicity. Individual pictures of children will not be published. No names will accompany any photographs on the website. (Note: Even if you do not have children as part of your group, please select either "yes" or "no" for the permission for children in order for your registration to be processed. Thank you.)

Photo Permission*:

	Yes	No
I GRANT permission for Holy Trinity Catholic Church to publish photographs of me on the church's website or in the church's publicity information, newsletters or bulletins. I understand that if I give written notice to the webmaster that I object to any particular picture of me on the website, it will be removed as soon as possible. I understand that I will not be paid any royalty or other compensation and I relinquish any right I may have to any payment if my photo is published.
I GRANT permission for Holy Trinity Catholic Church to publish photographs of my child(ren) on the church's website or in the church's publicity information, newsletters or bulletins. I further state that I have the right to grant or refuse this permission as I am the child's parent or legal guardian. I understand that if I give written notice to the webmaster that I object to any particular picture of my child(ren) on the website, it will be removed as soon as possible. I understand that neither my child nor I will be paid any royalty or other compensation and I relinquish any right I or my child(ren) may have to any payment if my photo is published.

Please select "Yes" or "No" for each of the above questions and then "sign" and list the date below.

Signature*:

Please enter your signature.

Today's Date:

Any Other Comments:

Please include any additional information which you want us to know.

If any of your information changes before September 24 (eg, address, email), please notify Cathy Quinn at cathy.quinn@verizon.net so we can keep our records updated.

See Frequently Asked Questions for more details.

When you have completed this form, please review the form to verify that you have completed all of the required items. Then click on "Submit" below. Once your form has been received, you will be taken to a confirmation page.

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2010 Camp Trinity Registration Form