2018 SUMMER CAMP REGISTRATION FORM

PLEASE FILL OUT THE SECOND PAGE OF THIS FORM AND SUBMIT IT WITH FULL PAYMENT BY MAY 1, 2018 TO

PINEWOOD SUMMER CAMPS327 FREMONT AVENUE | LOS ALTOS, CA 94024

REGISTRATION PROCEDURE

• The registration deadline is May 1, 2018.• Use ONE form for EACH student. A student may register for multiple camps on the same form; a

parent signature is required for processing.• Write a SEPARATE check for EACH camp; payable to EACH Camp Director. Full payment is

required at registration.• Mail registration form and payment(s) to:

Pinewood Summer Camps, 327 Fremont Avenue, Los Altos, CA 94024• Registrations cannot be accepted via FAX or telephone.

PLEASE NOTE

• Registrations are processed on a first come, first served basis, only when they are accompanied by full payment of fees.

• The Camp Director is responsible for sending confirmation of enrollment. Please contact him/her directly if you have questions.

• Email addresses for Camp Directors are listed on the Pinewood School website under Camp Schedules.

REFUNDS

• Camp fees are non-refundable after June 1, 2018. To request a refund before June 1st, please email the Camp Director.

• No adjustment of fees will be made if a camper withdraws prior to the end of a camp session; pro-rated refunds of camp fees are not available.

DATE/TIME FALL GRADES CAMP NAME CHECK PAYABLE TO FEE CAMPUS

June 4 - June 8 8:00 am - 3:00 pm 4-8 All Sports Camp Donna Owens $375 Upper

June 4 - June 8 8:30 am - 2:30 pm K-3 All Star Athletes Andrew Slayton $400 Lower

June 4 - June 8 3:00 pm - 5:30 pm 4-7 Keyboard, Coding, and Khan Linda Frolich $250 Upper

June 11 - June 15 9:00 am - 2:00 pm 5-12 MDT (Music • Dance • Theater)

Camp Katie Linza $375 Upper

June 11 - June 15 8:30 am - 2:30 pm K-3 BLAST! Camp Andrew Slayton $450 Lower

June 11 - June 15 8:00 am - 3:00 pm 4-8 Science, Sports, and Team Building Julie Lauer $375 Middle

June 18 - June 22 9:00 am - 3:30 pm 2-8 Curtain Up! Show Camp Lauren Post $400 Middle

June 18 - June 21 (M-Th) 10;00 am - 12:00 pm 8-12 Girls Varsity Soccer Whitney Wood $150 Upper

June 25 - June 29 9:00 am - 3:00 pm K-6 Craft and Water Mania* Kristine Kiene $425 Middle

August 14 9:00 am - 1:00 pm 7-9 UC Preparation Workshop Sabrina Strand $150 Upper

STUDENT NAME FALL GRADE HOME PHONE CELL

ADDRESS CITY ZIP EMAIL

I hereby authorize the staff of Pinewood Summer Camps to act according to their best judgment in any emergency required for my child, and I hereby waive and release the school from any and all liability for any injury incurred while at Pinewood School.

SIGNATURE DATE

*A Parental Permission, Emergency Consent and Waiver of Liability form is required for this camp. Please include a completed form with your registration. You may access the form via the Summer Camps web page at www.pinewood.edu/summer/summer-camps-2018

PLEASE FILL OUT THIS FORM AND SUBMIT IT WITH FULL PAYMENT BY MAY 1, 2018 TO

PINEWOOD SUMMER CAMPS | 327 FREMONT AVENUE | LOS ALTOS, CA 94024