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______ Week Date Theme Example June 15-19 The Hollywood Connection $________ $________ $_______ $_______ 1 June 13-17 Fantasy Fun $________ $________ $_______ $_______ 2 June 20-24 Roll On $________ $________ $_______ $_______ 3 June 27-July 1 No Siesta, All Fiesta $________ $________ $_______ $_______ 4 July 5-8 No Theme, All Fun $________ $________ $_______ $_______ 5 July 11-15 Island Adventure $________ $________ $_______ $_______ 6 July 18-22 The Sky Is The Limit $________ $________ $_______ $_______ 7 July 25-29 Fun & Adventure $________ $________ $_______ $_______ 8 Aug. 1-5 Games Galore / Outside the Box $________ $________ $_______ $_______ 9 Aug. 8-12 Outside the Box / Games Galore $________ $________ $_______ $_______ 10 August 15-19 Caribbean Carnival $________ $________ $_______ $_______ 185.00 Summer Sun Crew Total of the weeks and add on options 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. Weekly Summer Sun Crew & Summer Breezer Tuition: • Member pricing $189.00 for the frst child $129.00 for each additional child • Non-member pricing $199.00 for the frst child $139.00 for each additional child NOTE: Field trips are subject to change Add On Options: Fit Day - High energy one hour program for campers to improve strength and have fun. Select one or both days $10.00 per day Extended Care - Early drop off 7:30 AM and/or lte pick up 6:00 PM. $35.00 per week, per child If you have selected Member Pricing enter your Key Tag # here_____________ Extended Care Fit Day Total 35.00 20.00 240.00 2016 SIZZLIN' SUMMER CAMPS R6

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