Kelly Tours Trip Catalog

Camp Kelly

2010 Camp Kelly

“Learning in Motion”

Camp Registration Form

Camper Information

Last Name First Name

Street Address City _____________________  State _____ Zip _________

Home Phone (        ) ________________ DOB __ Age ________

Gender  □  Male     □  Female

Parent or Guardian Information Emergency Contact (different from parent or guardian)

Full Name Full Name ________________

Work or Daytime Phone (          ) Relationship to Child  ___________________________

Cell Phone  (          ) Daytime Phone (          ) ________________

Email Cell Phone  (          ) ________________

 

Ages: 10 – 15 years old

Classes: – Orienteering & Global Positioning

□   Session 2 ● July 19 – 23  (# 5842)                                                                     Systems

- Digital Photography

Camp Fee: $249.00                                                                                             – Art in the Park

Total Amount Enclosed $_____________________                                                 – Marine Science & Eco Cruise

Camp Location: Kelly Tours, 2788 Hwy 80 W

Select T-Shirt Size: (Adult Sizes)

□  Small                                   □  X-Large

□  Medium                                □  XX-Large

□  Large

Camp Price Includes: Roundtrip motor coach transportation for excursions, lunch, morning and afternoon snacks, 1:10 chaperone to student ratio, camp activities and supplies, t-shirt.

Transportation: Modern motor coach transportation will be provided for all camp excursions.  The motor coach will be operated by an experienced driver and have a restroom.

 

2009Camp Kelly

“Learning in Motion”

Camp Registration Form (cont.)

 

 

Payments: Please make all payments payable to Kelly Tours, Inc.  Checks, cash or money orders, or credit card payments are accepted.  Please include your driver’s license number and camp session on your check.  Call our office at 912-964-2010 for payment by credit card.  (A charge will be incurred on all checks returned for insufficient funds.  Questions concerning Express Checks can be directed to www.expresschecks.org)

Mail this registration form and payments to: Kelly Tours, Inc.

2788 Highway 80 West

Garden City, GA 31408

Important: Please be sure to fill out the camp registration form completely and send in with your payment.  Failure to fill out the camp registration form could result in your payment being returned, improperly posted or the child could be denied a space in the camp.

PLEASE NOTE: Camp Kelly of Kelly Tours, Inc. reserves the right to withdraw any camper whose influence or actions are deemed harmful or disruptive. In the event of dismissal or withdrawal, refunds are not possible. I certify that I have read and understood the information detailed in this application and that the information I have given and released is true and correct.

Parent’s or Guardian’s Signature __________________________________            Date ___________________________

I give Camp Kelly of Kelly Tours, Inc.  permission to use my child’s photo in future Kelly Tours advertisement items.

Parent’s or Guardian’s Signature __________________________________            Date ___________________________

Further comments concerning your child, including requests to be grouped with other campers (although we cannot guarantee these requests): ______________________________

_____________________________________________________________________________________________________

Please return this application along with the $100 deposit no later than July 1, 2010 to ensure enrollment in the session in which you have applied. This deposit is non-refundable.  The balance is due two weeks prior to the camp session in which you have applied.

If registering more than one camper please, complete a separate registration form for each.

A final letter will be sent to all campers prior to camp highlighting camp activities, the camp schedule, what to bring, and reminders.

 

Please, direct any questions to the office of Kelly Tours, Inc. at (912) 964-2010 or 1-800-442-6152.  Thank you.

Camp Registration Form (cont.)

 

Health Information

 

Medication child will be taking during the camp day and for what condition:

Medical Conditions:

 

Allergies (food, drugs, insect stings, etc.):

_____________

Date of Last Tetanus Shot: ____________________________

 

Insurance Company: _________________________________       Policy Number: _____________________________

EMERGENCY CARE: I hereby give the right and power to Kelly Tours, Inc. to authorize medical treatment, care and services, and make whatever decisions necessary for my child’s welfare while my child is a participant of 2009 Camp Kelly.  I understand that this authorization in no way relieves me of any financial or other obligations related to any decisions made by Kelly Tours, Inc. employees.  I agree to appoint Kelly Tours, Inc. as my agent for the purposes of obtaining medical treatment in the event of injury.  I agree to be responsible for all medical expenses incurred in connection therewith.  In the event Kelly Tours, Inc. incurs expenses for medical treatment, then and in that event I agree to reimburse Kelly Tours, Inc. in full.

Parent’s or Guardian’s Signature __________________________________            Date ___________________________