Huntersville Family Fitness & Aquatics

2016

Issue link: http://hffasummercamp.epubxp.com/i/636768

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Huntersville Family Fitness & Aquatics requires the following information and your authorization to charge your credit, debit or checking account for the weeks your child(ren) are attending our program. Child(ren)'s Name: _________________________________________________________________________________ Name as it appears on the card: ____________________________________________________________________ Credit Card Type: q Visa q MasterCard Credit Card # ____________________________________________________________ Name as it appears on Checking Account: ____________________________________________________________ Routing # ________________________________________ Bank Account # __________________________________ * One time annual family registration fee: Registration fee prior to April 1st Member- $20 Non-Member- $40.00 Registration fee prior to May 1st Member- $25.00 Non-Member- $45.00 Registration fee after May 1st Member- $30.00 Non-Member- $50.00 Charge Authorization Form By signing below, I hereby authorize HFFA to charge the above listed credit card or checking account for the non- refundable registration fee, non- refundable 10% deposit and the weeks indicated above for my child(ren) to attend camp. I understand this information is confdential and will be kept as a part of my records. I will notify HFFA if I change fnancial institutions or credit card numbers so that my payment is not delayed. Signature:_______________________________________________________________________ Date:________/________/20______ Total of the weeks selected $ __________ 10% of the total weeks $ __________ * Registration fee $ __________ Total due at registration $ __________ Enter the rate as it applies to your camper by each week that you wish to enroll your camper. 115.00 4 Fit2Splash ½ day camp (ages 6-12) Weekly Fit2Splash Tuition: •9:00 a.m. - 1:00 p.m. Member pricing • $99.00 for each child • No sibling discount offered Non-member pricing • $109.00 for each child • No sibling discount offered If you have selected Member Pricing enter your Key Tag # here_____________ 2016 SIZZLIN' SUMMER CAMPS Date Example q June 13-17 $____________ q June 13-17 $____________ q June 20-24 $____________ q June 27-July1 $____________ q July 5-8 $____________ q July 11-15 $____________ q July 18-22 $____________ q July 25-29 $____________ q August 1-5 $____________ q August 8-12 $____________ q August 15-19 $____________ R4

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