2013 YMCA CAMP EBERHART SUMMER REGISTRATION FORM
Complete the Registration Form, carefully marking the session(s) desired.
Please submit a separate form for each child you are registering. Registrations may be submitted in one of three ways;
  • you may submit this form online, and a representative from camp will contact you to complete a credit card transaction over the phone. We accept Visa, Mastercard, Discover or American Express.
    OR you may print this form and fax it to (269) 244-5000. Be sure to include your credit card number, expiration date, and 3 digit security code.
    OR
  • you may print this form and mail it with a check made payable to YMCA Camp Eberhart to;
       YMCA Camp Eberhart
       Summer 2013 Registrations
       10481 Camp Eberhart Road
       Three Rivers, MI 49093
The registration must be accompanied by a non-refundable deposit of $100 per week of camp plus the total fee for special programs. The deposit will be applied to camp fees. The balance is due May 1. (If you are registering after May 1, the total fee must accompany the registration. There will be a $25 late fee if payment is received after May 1.)

Once registered, you will receive a letter of confirmation and a Parent Information Packet.
Please note: All specialty programs are subject to space availability. If a popular session is already filled, you will be put on a waiting list, and contacted about your options.
Birthdate: Age When Attending Camp: Grade Entering Fall 2013: Sex: MF
Camper's Full Name:
Address:
City:State:Zip:County:
Parent/Guardian:
Email Address:
Home Phone: Cell Phone:
Bunkmate Name:
(We will attempt to accommodate up to 2 bunkmates of same age/gender)

PERMISSION RELEASE STATEMENT: I certify that the proposed camper is in normal health and subject to ordinary camp discipline. I understand that the minimum of $100 per week non-refundable deposit is included in the camp fee, and that my child's camp week will only be reserved upon receipt of this deposit. In addition, I understand that my child may be photographed, and give consent to use these photos by YMCA OF MICHIANA, INC. for marketing purposes.

Please click on this field to affirm that
you have read the PERMISSION RELEASE STATEMENT


Are you a new or returning camper?
New Camper
Returning Camper

How did you hear about Camp Eberhart?


Are you a YMCA Member ($35 discount for YMCA Members)? Yes No
If yes, where?Membership ID Number:

When you give to YMCA CAMP EBERHART, you make a meaningful impact in the lives of children. Please give what you can to help sponsor other campers:
$100 $50 $25
Thank you!
You can spread your camp fees out monthly through our EZ payment plan. Please check here:
Please bill me monthly
Debit my credit card monthly
(All balances are due by May 1, 2013)



Please indicate which week(s) you would like to attend YMCA CAMP EBERHART and up to four programs for each week

Camp Session
6/16
6/23
6/30
7/07
7/14
7/21
7/28
8/04
8/04-
8/17
Best Rates
Register by
12/31/12
Early Bird
Register by
2/28/12
Standard
Rates after
3/01/12
TOTAL
Day Camp entering K-4
M-F 8:30am-5pm
1
2
3
4
5
6
7
8
 
$152
$156
$159
 
3-Day Resident Camp
entering grade 2-11
1
3
           
$394
$404
$415
 
Traditional Resident Camp
entering grade 2-11
1
2
3
4
5
6
7
8
$583
$597
$612
 
Additional Week/
Family Members
1
2
3
4
5
6
7
8
$534
$567
$582
 
Outdoor Living (NEW)
entering grade 10-11
 
           
8&9
$902
$926
$950
 
Counselor-In-Training*
entering grade 11 & 16y/o
 1-3
  5-7
     $1130** $1158** $1187**  
*Must apply for acceptance into the CIT program. **Per 3-week session
PROGRAMS
 
Waterskiing/
Wakeboarding
1
2
3
full
full
full
full
8
 
$72
$109
$130
 .
High Challenge - 2 periods
entering grades 8-11
1
2
3
4

5

full

7

8
 
$72
$109
$130
.
Horse Masters - 2 periods
entering grades 5-11
1
2
3
full
5

6
7
8
  
$72
$109
$130
.
Horseback Riding
entering grades 4-11
1
2
3
full
full
full
7
8
 
$35
$51
$63
.
Tower Challenge
entering grades 4-11
1
2
3
4
full
full
7
8
 
$35
$51
$63
.
Trail Biking
entering grades 7-11
1
2
3
4
5
6
7
8
 
$35
$51
$63
.
Astro Camp - 2 periods
entering grades 5-11		      4
     
$35
$51
$63
.
Stay-over Saturday Night
6/22
6/29
7/6
7/13
7/20
7/27
8/3
   
$25/weekend
.
 These programs are on a first come, first served basis.
Special programs are very popular. To ensure a spot, please register early and pay for them with your registration deposit.  If they are full, you will be notified on your fees statement that you are on a waiting list, and your fees will be credited to your store account. After May 1, the total fees are due with your registration. Registrations are taken as long as there are openings. Store Deposit
(we recommend approximately $30 per week)
TOTAL FEES .

If you know of someone who would like to come to camp but is in need of financial assistance, our special "campership" may be available. Contact Camp Eberhart at 1-888-YCAMPEB or (269) 244-5125. Applications must be submitted by April 1.

In an effort to better accommodate program interest we would like to know your child’s top 3 program preferences. This is just a survey… we are not guaranteeing your camper will have these programs when they arrive…we just want to better our staffing to some of the most popular programs in hopes of your child having the best possible experience while they are here.

Please mark 3 program choices that your child would be most interested in when they attend camp:
Archery
Astronomy
Boats, Canoes & Kayaks
Ceramics
Crafts
Drama
Fishing
Land Sports
Nature
Photography
Riflery
Rocket Building
Sailing
Swimming

ALL REFUNDS WILL BE PROCESSED WITHIN 6-8 WEEKS OF THE END OF THE SUMMER, ONCE THE BOOKS HAVE BEEN CLOSED. PLEASE EXPECT ANY REFUND NO EARLIER THAN LATE SEPTEMBER

If you need assistance or have questions about this form, please contact
Camp Eberhart -- we'll be happy to assist you:

Phone (269) 244-5125
FAX (269) 244-5000
Toll Free (888) 922-6732
e-mail: office@ymcacampeberhart.org
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