Registration+form

MATH MARVELS SUMMER CAMP REGISTRATION FORM http://flynnwikiworld.wikispaces.com/Math+Marvels+-+Summer+camp+2015

Student Name __­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­____­­­­­­­­__

__ Parent Name ___

Parent Phone & E-Mail_____

__ Student’s Grade in 2015-2016 school year ____

Which grade level would you like to join? Circle one. ( all classes run on Tuesday and are one hour in length)
 * o 1st grade – 1:00 – 2:00
 * o 2nd grade – 2:00 - 3:00
 * o 3rd grade – 3:00 – 4:00
 * o 4th grade – 4:00 – 5:00
 * o 5th grade – 5:00 – 6:00

CHOOSE YOUR WEEKS X $35.00 PER WEEK
 * Week 1 – July 7th ||  ||   ||
 * Week 2 – July 14th ||  ||   ||
 * Week 3 – July 21st ||  ||   ||
 * Week 4 – July 28th ||  ||   ||
 * Week 5 – August 3rd ||  ||   ||
 * Week 6 – August 10th ||  ||   ||
 * Week 7 – August 17th ||  ||   ||
 * Initial material fee ||  || $5.00 ||

Commit to all 7 weeks and receive a $10 discount off the total. (must pay total at registration) Commit to 4 weeks and receive a $5 discount off the total. (must pay total at registration) Sibling discount: $30 per week

Or you can pick your weeks and pay as you go.

Total number of weeks: _ X $35 ($30 for siblings) = .00 Initial material fee + 5.00

Total: .00 Apply Discount (if applicable) Minus .00

Total Amount Enclosed: .00

Check may be made payable to: Terri Flynn 707 Ramapo Valley Road Mahwah, NJ 07430 201-644-7001 CELL 845-537-0266

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