T&D’s Animal Encounters

“Keeper For A Week"
Monday through Thursday
9:00am – Noon
Boys and Girls ages 10 -15
$100.00 per week/$25.00 non-refundable deposit
Registration Due by   June 03, 2011 for 1st Beginner Camp
                                            July 08, 2011 for Intermediate Camp
                                     July 22, 2011 for Advanced Camp

Name of Keeper:      
Sex:   M      F     Age:                                     
School:                                                                        Last Grade Completed:         

Special Needs (allergies, medications, etc): (please explain)

                                 
Parent/Guardian Name:  
Mailing Address:  
City:                                                     State:                           Zip Code:   
Home Phone:                                                                          Work Phone:  
Emergency Contact Person:                                                  Emergency Contact Person’s Daytime Phone Number:  
Free T-shirt for Campers: Circle one
(Child) Medium       (Child) Large       (Adult) Small      (Adult) Medium      (Adult) Large

Which camp week is your child participating in?  Circle one.
Your child must complete the camps in the following order.  For example, if your child wishes to participate in the Advanced camp, he or she must first complete both the Beginner and Intermediate camps.  Which camp week is your child participating in?  Circle one.

            Beginner June 20-24             Intermediate July 18-21                  Advanced August 8-11

Name* of person picking up your child at noon each day?
*Your child will NOT be released to anyone else without prior parental/guardian’s approval.
As the parent or guardian of the camper listed above, I give permission by signing below to the owners of T&D’s Cats of the World to take photos of my child for the camp craft. 

Signature _________________________                Date ___________

As the parent or guardian of the camper listed above, T&D’s Cats of the World has my permission to use my child’s photo to promote future T&D’s Animal Encounters camps.

Signature__________________________               Date___________
We expect your child to:
        Have fun, be respectful of others (humans and animals) and obey T&D’s rules.
T&D’s has the right to end the campers experience without refund if the camper is disrespectful to others or refuses to follow T&D’s rules.
Please send a $25.00 non-refundable* deposit with this registration form.  The remaining $75.00 camp fee will be due at 9:00 am the first day of camp.  Checks or cash only.   Make check payable to T&D’s Cats of the World. *If the week you have chosen is already filled, we will contact you by phone to offer an alternative week or refund your money.            Registration Form and Deposit DUE AT THE ABOVE DATES     
P.O. Box 186, Penns Creek, PA 17862                                 570-837-3377