Summer Camp 2014

1. Summer Camp 2014 • Registration begins • March 1, 2013 Return forms to: PO Box 1015 Waldorf, Maryland 20604 Or stop in and see us at: 71 Industrial Park Drive Waldorf, MD 20602 • All camp fees are $175.00 • All camps run from 9:00am – 4:00pm Child’s Name____________________________ Birthdate____________________ Parent/Guardian Name ___________________Email________________________ Mailing Address ______________________ City________________ Zip________ Home Phone _______________________Cell Phone _____________________ How did you hear about us? ___________________________________________ Payment Information: Check payable to HSCC Cash Credit Card # __________________________ Billing Address __________________________ City___________ State________ Zip ___________ Exp. Date _________ ___________________________ Authorized Signature No. of weeks of camp _________ x $ _________ + Scholarship donation_________ Sub Total = _________ less Financial Aid Discount__________ Volunteer Discount __________ Large Family Discount__________ (Payment Due 3 weeks before your child’s camp begins) Total paid __________ Balance __________