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Hornets Nest

2009 Cheshire YMCA Hornets Nest Registration

Camper's Name: *

Gender:

Birthdate (M/D/Y):

Nick Name:

Grade Completed June 2009:

Mailing Address:

Home Phone: *

City:

State:

Zip:

E-mail Address:

Mother's Name:

Work Phone:

Employer:

Occupation:

Father's Name:

Work Phone:

Employer:

Occupation:

Camper Lives with:

Mom & Dad

Mom

Dad

Other (Please include note)

Shirt Size:

Child

or Adult

Programs:

Buzz Kidz

Hornets Nest A week 1

Hornets Nest A week 2

Hornets Nest B week 3

Hornets Nest B week 4

Hornets Nest C week 5

Hornets Nest C week 6

Hornets Nest D week 7

Hornets Nest D week 8

Soar:

Soar A week 1

Soar A week 2

Soar B week 3

Soar B week 4

Soar C week 5

Soar C week 6

Soar D week 7

Soar D week 8

Amount: TBD

Care needed:

I will be dropping off and picking up my child from camp

I will need before camp care for my child, for an additional fee of $15

I will need after camp care for my child, for an additional fee of $10 per week

I will need before and after camp care for my child, for an additional fee of $25 per week

Comments:

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Cheshire YMCA’s Mission
To develop positive values that enrich the spirit, mind, and body by providing quality programming for all, with an emphasis on youth, in the Cheshire YMCA service area.

Cheshire YMCA ~ 32 Lake Street Swanzey, NH ~ mail to: P.O. Box 647 Keene, NH 03431
Voice: (603) 352-0447 ~ Fax: (603) 352-0516 ~ Email: info@cheshireymca.org
Copyright 2009 © Cheshire YMCA. All rights reserved.

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Hornets Nest