In Your righteousness deliver me and rescue me... Psalm 71:2

Join Us for a summer filled with:

Fun & Educational Exploratory Classes

Weekly Field Trips

Specialized Program for Primary Students

Fun Filled Theme Days

Guest Speakers

Arts & Crafts, Games, & Sports

Water Play & Swim Days

Optional Week Long Enrichment Camps

Save $10 on registration if registration

is Completed by Friday, May 18th

In a Hurry? Register quickly on the

***Week #1 June 18th — 22nd*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Fun On Campus Movies@Triangle Knott’s Soak Summer Kick Activities (Incredibles 2) City Off Party

***Week #2 June 25th — 29th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Games In/Games Out Bowling @ Irvine Lanes California Reptile Show Weird Science Science Center Adventures in Art Jr. Mates: Dino-Mite!

***Week #3 July 2nd — 6th No Camp July 4th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Games In/Games Out Roller Skating Little Corona Castaway Day Weird Science FV Skate Center Beach& Tide Pools Mini Golf/Treasure Hunt Adventures in Art Jr. Mates: Circuits for Kids

***Week #4 July 9th — 13th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Vacation Bible School Sky Zone Johns Incredible Minute 2 Win It All Week Long Pizza Cost included in Camp

***Week #5 July 16th — 20th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Creators Challenge Kayaking @ NAC Knott’s Berry Nerf Wars Comic Book Makers Farm Foods of the World Jr. Mates: Magnets In Motion

***Week #6 July 23rd — 27th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Creators Challenge Balboa Fun Zone San Diego Zoo Mad Science Day Comic Book Makers Science Presentation Foods of the World Jr. Mates: Super Science Sleuths

***Week #7 July 30th — August 3rd*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Robotics for Beginners Rock Climbing Disneyland Travel to the Stars Bake Me A Cake Rockreation Inflatable Planetarium Twisted Sports Jr. Mates: Out of this World

***Week #8 August 6th — 10th*** Exploratory Clubs: Terrific Tuesday: Field Trip: Fun Friday: Robotics for Beginners Roller Skating OC Fair Super Hero Day Bake Me A Cake FV Skate Center Twisted Sports Jr. Mates: Lego Engineering

***Week #9 August 13th — 17th*** Mon: Inventors Challenge Terrific Tuesday: Field Trip: Fun Friday: Tues: Who Done It? Kids Choice Raging Waters End of Camp Wed: Game Show Mania BBQ & Party Junior Mates: Crazy Creators

Christ Lutheran School Age Care - Summer Camp 2017 Registration Form

Child’s Name:_____________________________________ Grade Fall 2017:_______

Address:____________________________________________________________

Family E-Mail:________________________________________________________

Parent’s Name:____________________________ Main Phone#:_________________

Please Circle Shirt Size: Youth S M L Adult S M L

Please Mark All Days Needed, Circling Half Day or Full Day - Days May Be Changed After Registration

Payments will be charged to FACTS Tuition Accounts Please Sign Authorization on Policy Agreement

All Students Attend Thursday Field Trips

Terrific Tuesday Field Trips are optional for 3rd Grade & Up (Additional Cost)

Wet Wednesdays are not available to Incoming Kindergarten Students

All Fees are collected through FACTS Tuition, to set up an account, please visit

https://online.factsmgt.com/SignIn/3D16Q

Full Time 7am-6pm

Includes Field Trip

$220

Daily Rate 7am-6pm

not valid on Thursday

$55

Field Trip Rate

(Thursdays)

$80

Half Day Rate

7am-12/12-5pm

$30

Drop In Care

Daily Rate

$75

Exploratory Clubs Mon-Wed 8am-12:00

$80

June 18 - 22 Example

19 X Half Day Full Day

18

On Campus Activities

Half Day Full Day

19 Terrific Tuesday Movies@Triangle

Incredibles 2 Half Day Full Day

22

Wet Wednesday: Beach Day

Half Day Full Day

21

Field Trip: Knott’s Soak City

No 1/2 days

22

Summer Kick Off

Party Half Day Full Day

Payment Method

Facts 6/11

Amount Due:

$__________

June 25 - 29 Exploratory Clubs Session #1 Games In/Games Out Weird Science Adventures In Art Junior Mates: Dino-Mite!

25

On Campus Activities

Half Day Full Day

26 Terrific Tuesday

Bowling @ Irvine Lanes

Half Day Full Day

27

Wet Wednesday: Pool Day

Half Day Full Day

28

Field Trip California Science

Center No 1/2 days

29

Reptile Day Reptile Show

Half Day Full Day

Payment Method

Facts 6/18

Amount Due:

$__________

July 2 - 6 Exploratory Clubs Session #1 Games In/Games Out Weird Science Adventures In Art Junior Mates: Circuits for Kids

2

On Campus Activities

Half Day Full Day

3 Terrific Tuesday

Roller Skating@ FV Skate

Half Day Full Day

4

No Camp Today

5

Field Trip Little Corona Beach

& Tide Pools

No 1/2 days

6 Castaway Day

Mini Golf/Treasure Hunt

Half Day Full Day

Payment Method

Facts 6/25

Amount Due:

$__________

July 9 - 13

VBS The cost of VBS is included in your weekly tuition.

9 VBS

On Campus Activities

Half Day Full Day

10 VBS Terrific Tuesday

Sky Zone Jump Half Day Full Day

11 VBS Wet Wednesday

Pool Day

Half Day Full Day

12 VBS

Field Trip John’s Incredible

Pizza No 1/2 days

13 VBS

Minute 2 Win It Games Day

Half Day Full Day

Payment Method

Facts 7/02

Amount Due:

$__________

July 16 - 20 Exploratory Clubs Session #2 Creators Challenge Comic Book Makers Foods of the World Junior Mates: Magnets in Motion

16

On Campus Activities

Half Day Full Day

17 Terrific Tuesday

Kayaking @ Newport Aquatic

Half Day Full Day

18 Wet Wednesday

Beach Day Half Day Full Day

19

Field Trip Knotts Berry Farm

No 1/2 days

20

Nerf Battle

Half Day Full Day

Payment Method

Facts 7/09

Amount Due:

$__________

July 23- 27 Exploratory Clubs Session #2 Creators Challenge Comic Book Makers Foods of the World Junior Mates: Super Science Slueths

23

On Campus Activities

Half Day Full Day

24 Terrific Tuesday

Balboa Fun Zone Half Day Full Day

25 Wet Wednesday

Pool Day

Half Day Full Day

26

Field Trip San Diego Zoo

No 1/2 days

27

Mad Science Science Show

Half Day Full Day

Payment Method

Facts 7/16

Amount Due:

$__________

July 30 - August 3 Exploratory Clubs Session #3 Robotics for Beginners Bake Me A Cake Twisted Sports Junior Mates: Out of this World

30

On Campus Activities

Half Day Full Day

31 Terrific Tuesday

Newport Dunes Water Park

Half Day Full Day

1 Wet Wednesday

Beach Day

Half Day Full Day

2

Field Trip Disneyland

No 1/2 days

3 Travel to the Stars

Inflatable Planetarium

Half Day Full Day

Payment Method

Facts 7/23

Amount Due:

$__________

August 6 - 10 Exploratory Clubs Session #3 Robotics for Beginners Bake Me A Cake Twisted Sports Funbots Club: Lego Engineering

6

On Campus Activities

Half Day Full Day

7 Terrific Tuesday

Rock Climbing Rockreation

Half Day Full Day

8 Wet Wednesday

Pool Day

Half Day Full Day

9

Field Trip Orange Couty

Fair No 1/2 days

10

Super Hero Day

Half Day Full Day

Payment Method

Facts 7/30

Amount Due:

$__________

August 13 - 17 Monday: Inventors Challenge Tuesday: Who Done It? Wednesday: Game Show Mania Junior Mates: Crazy Creators

13

On Campus Activities

Half Day Full Day

14 Terrific Tuesday

Kids Choice Half Day Full Day

15 Wet Wednesday

Beach Day Half Day Full Day

16

Field Trip Raging Waters

No 1/2 days

17 Last Day of Summer

Whacky Water Day BBQ & Party

Half Day Full Day

Payment Method

Facts 8/06

Amount Due:

$__________

Full Time (7:00am - 6:00pm) $220.00 per week (Includes Thurs Field Trip)

Daily Rate (7:00am - 6:00pm) $60 per day

Drop In Rate (7:00am - 6:00pm) $80 per day

Thursday Field Trip Only Daily Rate $80 per day

1/2 Day Rate not available on Thursday Field Trips

Exploratory Classes Only $80 per week

(Mon-Wed 8am-12noon)

1/2 Day Rate (7:00am-12:00/12:00-5pm) $35 per day

1/2 Day Rate not available on Thursday Field Trips

Registration Fees

CLS Families Early Registration until 5/18 $50 per camper

Non CLS Families Early Registration until 5/18 $75 per camper

CLS Families Registration after 5/18 $60 per camper

Non CLS Families Early Registration after 5/18 $85 per camper

10% sibling discount available on tuition

1/2 day rates apply to campers who are also enrolled in week-long enrichment camps. No 1/2 day care available on Thursdays.

All Fees are collected through FACTS Tuition, to set up an account, please visit

https://online.factsmgt.com/SignIn/3D16Q

Tuition:

I agree to pay all tuition and fees required in accordance with the Tuition Policy. Tui-

tion is charged through our FACTS Tuition system. Tuition will be charged to your

account on the Monday before your child’s attendance. A late fee of $20 will apply to

all late payments. Please sign the authorization below to allow this withdrawal:

I hereby give Christ Lutheran permission to charge my weekly Summer

Camp fees to my FACTS Tuition account:

_____________________________________________________

Signature Date

Late Pick Up Fees:

There is a late pick-up fee of $1.00 per minute, per child past 6:00pm, unlimited.

This fee will be added to your FACTS Tuition Account.

Policies:

Discipline: Should there be a behavior/discipline problem w ith your

child during the Summer Camp program, you may be called to pick-up your child im-

mediately at the discretion of the SAC Director. If a child continues to have a behav-

ior/discipline problem, he/she may be removed from the Summer Camp program at

the discretion of the SAC Director.

Handbook: I have read the SAC Sum m er Handbook and agree to adhere

to all the policies and procedures stated within.

Signature _______________________________ Date _______________

Student Name _______________________________________________

Legal Name of Student ______________________________________ Male Female

Last First M.I.

Address _______________________________ City ________________ Zip _________

Home Telephone ( ) ______________ Date of Birth ____________ Grade in Fall _______

Father’s Name _____________________ Mother’s Name __________________________

Address _________________________ Address _______________________________

(if different from student) (if different from student)

Home Phone ( ) __________________ Home Phone ( ) _________________________

(if different from student) (if different from student)

Cell Phone ( ) ____________________ Cell Phone ( ) _______________________

Work Phone ( ) ___________________ Work Phone ( ) ______________________

This child is living with… Both Parents Father Only Mother Only Father & Stepmother

Mother & Stepfather Other (explain)___________________

If divorced, who has legal custody of student? Father Mother Joint Custody

Is there any physical condition, which needs special consideration in the event of emergency, such as

allergies to medicine or food, a cardiac condition, diabetes, etc.? _________________________

_____________________________________________________________________

In the event that my child should have a sudden illness or an accident and the home cannot be reached, I here-by request that one of the following physicians be called to render first aid and or emergency treatment. It is also understood that if it is judged that immediate emergency care is necessary that I authorize the school or its designee to contact the emergency medical service for immediate treatment. It is understood that I will pay any and all fees incurred by such treatment, which are not immediately available, the school may select one for such treatment, and I will be responsible for the fees incurred. This agreement will be in effect as long as this student is enrolled unless revoked by the parent in writing.

Child’s Doctor: _______________________ City ___________________ Phone: ______________

Child’s Dentist: _______________________ City ___________________ Phone ______________

Preferred Hospital: _______________________________ City ___________________________

Medical Insurance Carrier: __________________________ Policy Number: ___________________

Person’s authorized to contact for emergency and/or pick up child from school other than mother and father listed above

Signature of Parent or Legal Guardian: _____________________________Date:_______________

Name Relationship Home Phone Work Phone Cell Phone