St. Ann’s by the Sea Summer Bible Camp Registration Form

July 21-24 from 9:00-12:00



Parent Name                                        Telephone                             E-mail

____________________________    _____________________   ________________________



Children’s names                                  Age                  Allergies / Medical concerns

___________________________      ________        ___________________________________

___________________________      ________        ___________________________________

___________________________      ________        ___________________________________

___________________________      ________        ___________________________________

___________________________      ________        ___________________________________

___________________________      ________        ___________________________________



When will your child be attending?                    Choose payment amount (price is for all 4 days)*:

___ Tuesday, July 21                                        ___ Individual -- $25

___ Wednesday, July 22                                  ___ Family (2+) -- $40

___ Thursday, July 23

___ Friday, July 24

___ All (4 day session)                             Attending BBQ:    Yes____   No______                                     

                                                                   Number people attending: Adult ____   Child____



*The cost is $25 for one child or $40 for a family regardless of the number of days attending.

Scholarships available.  Please contact the office for more information.



Make checks payable to St. Ann’s by the Sea.



Emergency contact name: ______________________________________

Home phone ____________________________Cell number____________________________



Please print and mail this form, along with a check to:

St. Ann’s by the Sea

591 Ocean Street

Marshfield, MA 02050



Please respond by July 1, 2009.



If you have questions, contact Karen or Amy at 781-834-4953.  You may also register or send inquiries via email at cm@stanns.net.





Parent/Guardian Signature: ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_______________________________________________________



Note:  Please sign Media Release in addition to registration.  Thank you.