UCAL Summer Camp Registration Form

University City Arts League
2010 Summer Camp REGISTRATION FORM
Please complete and submit your $25 Non-refundable deposit by June 14th
Contact the Arts League at 215-382-7811 for pricing information

Camper Name __________________________		Parent or Caregiver Name _________________________
Age __________ Grade in Fall '10 __________		Address _______________________________________
		Phone & Email __________________________________

	Session 1 (July 5th-16th)
	Session 3 (July 19th-30th)
	Session 4 (August 2nd-13th)
	Session 2 (August 16th-20th)
	Before Care ($5/day)
	After Care ($10/day)		(cost)___________

Camper Name __________________________		Parent or Caregiver Name _________________________
Age __________ Grade in Fall '10 __________		Address _______________________________________
		Phone & Email __________________________________

	Session 1 (July 5th-16th)
	Session 2 (July 19th-30th)
	Session 3 (August 2nd-13th)
	Session 4 (August 16th-20th)
	Before Care ($5/day)
	After Care ($10/day)		(cost)___________

Camper Name __________________________		Parent or Caregiver Name _________________________
Age __________ Grade in Fall '10 __________		Address _______________________________________
		Phone & Email __________________________________

	Session 1 (July 5th-16th)
	Session 2 (July 19th-30th)
	Session 3 (August 2nd-13th)
	Session 4 (August 16th-20th)
	Before Care ($5/day)
	After Care ($10/day)		(cost)___________


	Subtotal	_________________________
	-Discounts (multiple sign-ups)	_________________________

	Total Cost	_________________________
	Amount Enclosed	_________________________
	Visa/MasterCard Info (#, exp.date & name)	_________________________

For questions, contact jeanene at the UCAL office: 215-382-7811 · jeanene@ucartsleague.org · fax: 215-382-3339
Fax or call in VISA or MasterCard info. Please make checks and money orders payable to:
University City Arts league 4226 Spruce Street Philadelphia, PA 19104