2019 APPLECROSS JR. GOLF CAMP REGISTRATION FORM PLEASE SUBMIT ONE SET OF REGISTRATION FORMS PER CHILD FOR EACH WEEK OF CAMP. COMPLETE ALL SECTIONS; INCOMPLETE FORMS WILL DELAY PROCESSING. Camper s Name: Age: M / F Street: City, State, Zip: Primary Cntact Name: Cntact #2 Name: Phne: Email: Phne: Email: In an effrt t prvide adequate camp staff, all registratin frms must be received and paid in full by the THURSDAY 4PM registratin deadline (4 days prir t the registratin week chsen). All registratin frms submitted after the Thursday 4pm deadline will be charged the late registratin rate fr the week. Junirs must participate in ne entire week f camp during the current 2019 seasn befre registratin fr individual days will be accepted (1-4 days per week). SUMMER CAMP PRICING (All rates belw are Cash/Check Discunted Prices ) MEMBERS GUESTS Early Bird Registratin Full day weekly rate thru March 15, 2019 early registratin deadline, FIRM! $360 / week $410 / week Full Day Camp Sessin Regular weekly rate, 9am-4pm $410 / week $460 / week Sibling Rate Discunt rate fr each additinal sibling registered during the same week $385 / week $435 / week Multiple Weeks Rate Discunt rate when registering fr tw r mre weeks, paid upfrnt $385 / week $435 / week Daily Rate Daily full day rate, available nce camper has attended 1 full week during 2019 seasn $87 / day x $97 / day x Late Registratin Weekly full day rates fr 1 st child and siblings when registering after the Thursday 4pm registratin deadline (4 days prir t the participating week) $435 / week, $410 / week $485 / week, $460 / week Half Day Camp Sessin Regular weekly rate, 9am-12pm $260/week $310 / week Daily Rate Daily half day rate, available nce camper has attended 1 full week during 2019 seasn $57 / day x $67 / day x Late Registratin Weekly rate fr all half day campers when registering after the Thursday 4pm registratin deadline (4 days prir t the participating week) $285 / week $335 / week SUMMER CAMP OPTIONS (Please mark the apprpriate rates and specify individual days.) DAILY # WEEKLY Early Camp Care 8am-9am $10 / day $45 / week After Camp Care 4pm-5:30pm $12 / day $55 / week Early & After Camp Care 8am-9am & 4pm-5:30pm $20 / day $90 / week Bnus Lunch Hur 12pm-1pm, 1 hur added t Half day nly (must purchase at time f registratin) $8 / day $35 / week Applecrss Bx Lunch Sandwich, fruit, 2 snacks & drink (must purchase at time f registratin) $8 / day $35 / week Please prvide all required infrmatin.* Applecrss Membership #: Applecrss Guest: Check the crrespnding bx t chse the full week and specify individual days (M, TU, W, TH, F) n the line if applicable: Week 1: June 10-14 Week 4: July 8-12 Week 8: August 5-9 Week 2: June 17-21 Week 5: July 15-19 Week 9: August 12-16 Week 3: June 24-28 Week 6: July 22-26 Week 10: August 19-23 ** NO CAMP THE WEEK OF: July 1-5 ** Week 7: July 29-Aug 2 Girls: I wuld prefer t be gruped with Just Girls during glf camp whenever pssible. Cash: Enter Check #: (Check payable t Eric MacCluen Glf LLC) Amunt Enclsed: Credit Card Infrmatin*: Card Hlder Name (print): Visa MC Credit Card #: - - - Expiratin: Billing Street: Billing Zip: CVC Cde: Signature: Date: Charge Amunt: *All Summer Camp rates listed abve are Cash/Check Discunted Prices. Prcessing fees will apply t the ttal purchase amunt when paying by credit card. Credit card infrmatin is required fr all camp registrants even if paying by cash r check. Applecrss Cuntry Club members paying by credit card must prvide card infrmatin (DO NOT write card n file ) and enter membership number abve. Check payments returned due t insufficient funds will be autmatically charged the late registratin rate and a $25 bunced check fee. Any camp fees later assessed and nt paid when due may be charged t yur card and are authrized by the signature prvided; including late registratin fees, change f camp date(s) fees, r child care fees fr early arrival/late pickup. Please submit cmpleted registratin frms, emergency/waiver frm and payment t the Applecrss C.C. glf shp at: 170 Zynn Rad, Dwningtwn, PA 19335 r mail t: Eric MacCluen Glf LLC, 824 Tremnt Drive, Dwningtwn, PA 19335. If paying by credit card yu may send all frms via email (PDF frmat nly): hllymaccluen@yah.cm r fax t: 484-364-4408. All registratin frms must be cmplete and full payment must accmpany all frms t be enrlled in the Applecrss Junir Glf Camp.
First Name: Last Name: *COMPLETE ONE FORM PER CAMPER FOR EACH WEEK IN ATTENDANCE. DO NOT SUBMIT ONE FORM FOR MULTIPLE CHILDREN. Applecrss Glf Prgram Release and Waiver f Liability, Assumptin f Risk, and Indemnity and Parental Cnsent Agreement: Read Carefully! 1) I hereby release and discharge Eric MacCluen Glf ( EMG ) and Applecrss Cuntry Club ( ACC ), their agents, emplyees, staff members, directrs and fficers frm any claims, respnsibilities r liabilities fr injuries as a result f my participatin and/r my child s participatin as a player r spectatr in prgrams and activities at ACC. I fully understand that: these activities invlve risks and dangers f serius bdily injury r death, ( Risks ); these Risks and dangers may be caused by my wn actins r inactin s, the actins r inactin s f thers participating in the activity, the cnditin in which the activity takes place, r the negligence f the Releasee s named belw; there may be ther risk and scial and ecnmic lsses either nt knwn t me r readily r freseeable at this time; and I fully accept and assume all such risks and all respnsibility fr lsses, csts, and damages I incur as a result f my participatin r that f the minr in the Activity. I authrize EMG and ACC, their agents, emplyees, staff members, directrs and fficers t take whatever actin is necessary, in their best judgment, in an emergency and I hereby release discharge EMG and ACC, their agents, emplyees, staff members, directrs and fficers frm any respnsibility r liability related theret. 2) I hereby grant EMG and ACC permissin t use my and/ r my child s name, picture, r likeness in any printed media r any frm f advertisement. I fully renunce any and all claims upn EMG and ACC fr reimbursement fr use f this material. Cancellatin/ Refund and Change f Dates Plicies: Read Carefully! Cancellatin/ Refund Plicy: All requests fr cancellatin must be made in writing a minimum f ne week prir t the start f the registered camp week via email t: hllymaccluen@yah.cm. N cash refunds will be given under any circumstance. All mnies paid, with the exceptin f a $75 administratin fee, will be issued in the frm f tuitin credit that can be used tward any ther prgram with Applecrss Glf Academy featuring Eric MacCluen Glf. Tuitin credit must be used by the end f the calendar year. N refund r tuitin credit f any kind will be given if written cancellatin is made less than ne week prir t the start f the registered camp week, regardless f the nature f cancellatin. NO EXCEPTIONS. Change f Dates Plicy: We ask that yu make every effrt t attend yur registered camp week/ days as we prvide staff accrding t the number f students anticipated in attendance each day. If yu are unable t attend a scheduled camp week r day please ntify EMG in writing via email t: hllymaccluen@yah.cm. A minimum f a ne week s ntice prir t the registered camp week r 24 hurs ntice prir t any individual day is required fr participatin in anther camp week/ day. A missed camp week/ day withut the apprpriate prir written ntificatin is cnsidered unexcused and will nt be rescheduled, regardless f the nature fr nt attending. A $25 administrative fee applies fr each changed week and a $5 fee applies fr each changed day. This fee will be due when scheduling the new week/ day. Finally, inclement weather, bumps/ cuts/ blisters/ etc., the number f bys/ girls r ages f bys/ girls in attendance at any given time are beynd ur cntrl and are nt valid excuses fr cancellatin r changing dates. With my signature prvided belw, I acknwledge that I have read & understand all the infrmatin presented in the Applecrss Junir Glf Camp Parent Letter prvided & have retained a cpy. I have read, understand & accept all terms and cnditins t the infrmatin presented in the Applecrss Glf Prgram Participatin Waiver abve. I have read, understand & accept all terms and cnditins t the infrmatin presented in the Applecrss Glf Camp Cancellatin/ Refund & Change f Dates Plicy abve. Print Child s Name: Print Parent s name: Parent s Signature: Date:
First Name: Last Name: *COMPLETE ONE FORM PER CAMPER FOR EACH WEEK IN ATTENDANCE. DO NOT SUBMIT ONE FORM FOR MULTIPLE CHILDREN. Pick-up Infrmatin: The fllwing peple may pick up my child. Prper identificatin may be required. Name: Relatinship: Name: Relatinship: Name: Relatinship: Name: Relatinship: Emergency Cntact Infrmatin (Required): Please list three peple wh may be cntacted in case f an emergency. Emergency Cntact #1: Relatinship: Phne: Alt. Phne: Emergency Cntact #2: Relatinship: Phne: Alt. Phne: Emergency Cntact #3: Relatinship: Phne: Alt. Phne: Medical and Insurance Infrmatin (Required): *Campers may nt participate in Junir Glf Camp if Medical and Insurance infrmatin is nt prvided belw. Des yur child have allergies? Y r N Allergic t: Des yur child carry an Epi-pen? Y r N Des yur child have ther medical cnditins that we shuld be aware f fr camp? Y r N Please describe: Name f Insured: Relatinship t Child: Insurance Prvider: Plicy #: Preferred Hspital in emergency:
SUMMER CAMP BOX LUNCH ORDER FORM Cmplete this frm ONLY if yu wish t purchase the Applerss Bx Lunch. Lunch must be purchased at the time f registratin and may nt be added at a later date. This frm must accmpany the riginal registratin dcuments. Camper s Name: Camp Week: Please prvide any FOOD allergies*: Des child carry an Epi-Pen? Y r N *Please be advised, the chef is unable t accmmdate any special dietary requests. Therefre, if yur child has severe fd allergies r dietary restrictins, we highly suggest yu prvide a lunch frm hme fr yur camper. Sandwich: Chice f ONE (1) per day Mn Tues Wed Thurs Fri Ham & Cheese Turkey & Cheese PB & J Fruit: Chice f ONE (1) per day Mn Tues Wed Thurs Fri Fruit Salad Orange Slices Snack: Chice f TWO (2) per day Mn Tues Wed Thurs Fri Celery & Carrts w/ Ranch Dressing Ckie Chips Drink: Chice f ONE (1) per day Mn Tues Wed Thurs Fri Bttled Water Apple Juice Lemnade Iced Tea Funtain Sda *Substitutins t the menu abve may be made at the discretin f the chef based n availability.
Page 1 f 2 Dear Junir Glf Camp Parents, In preparatin f attending the 2019 Junir Glf Camp at Applecrss Cuntry Club, I wuld like t prvide yu with imprtant infrmatin that will ffer answers t frequently asked questins and help make glf camp an enjyable experience fr everyne. Please carefully read this letter in its entirety since infrmatin may have changed frm past seasns as Applecrss Cuntry Club grws. We als ask that yu retain this camp infrmatin letter fr future reference. Glf Camp arrival and pickup infrmatin Campers must arrive and depart prmptly at their designated times and lcatins. We ask that yu always cnnect with a CAMP staff member at bth arrival and departure as drp-ff and pickup are ften busy due t glf utings, events, etc. Yu must als sign yur child in and ut each day fr it allws staff t cmmunicate any changes, help maintain accurate attendance recrds and ensure each camper s safety. Camp Arrival: Campers must be signed-in n time and prepared fr each day. Yu may nt drp ff any camper prir t the scheduled times withut prir authrizatin as there is ften much activity arund the glf curse in the mrning and staff may nt arrive at the prper lcatin befre the scheduled times. The Learning Center (LC) and Tregs Pavilin (TP) address is: 170 Zynn Rad, Dwningtwn, PA 19335. Early Care Campers shuld arrive at the LC lcated n the driving range n earlier than 8:00am. Regular Drp-ff - Campers shuld arrive at the TP between 8:50-9:00am lcated t the rear f the ld clubhuse building (behind Tregs Restaurant). Any camper that needs t arrive prir t 8:50am must get prir apprval and will be charged fr early care, the $10 early care fee may be autmatically charged t yur credit card if nt paid at drp-ff. Camp Pickup: Campers must be signed-ut n time each day. Please nte: Afternn pick-up lcatins have changed this year frm previus summers since the Pulte Welcme Center will nt be available. Half Day - Campers are t be picked up frm the TP. Please arrive prmptly fr pickup by 12:00pm. Any Half Day camper picked up after 12:10pm will be charged fr ur Bnus Lunch Hur time that day the $8 fee may be autmatically charged t yur card if nt paid at pickup (n charge if campers arrive after 12:10pm). If yur camper is staying fr the Bnus Lunch Hur, please arrive prmptly by 1:00pm. Full Day - Campers are t be picked up at the TP. Please arrive prmptly fr pickup by 4:00pm. Any Full Day camper picked up after 4:10pm will be charged fr after care that day - the $12 fee may be autmatically charged t yur credit card if nt paid at pickup (yu wn t be charged if the campers have nt returned by 4:10pm). Als, yu must let us knw if yu plan t pick up yur camper any time befre 4:00pm by nting the time in the cmment sectin f the check-in/ut sheet. Please try nt t pick up full day campers prir t 3:00pm as this may cause a disruptin t planned activities fr the entire grup. If pickup prir t 3pm cannt be avided, yu will need t crdinate a time and place fr pickup with an instructr when yu arrive in the mrning. After Care - Campers are t be picked up at the TP. Please arrive prmptly fr pickup by 5:30pm. Our staff may ften be scheduled t teach r assist ther prgrams after camp. Therefre, any camper picked up after 5:30pm will be charged $5 fr every 10 minutes late after that time - the $5 fee per every 10 minutes may be autmatically charged t yur credit card if nt paid at pickup. *Campers may ccasinally get prir permissin t g t the LC during after care time t practice until pickup. Campers must get prir permissin frm Eric MacCluen t avid any class r lessn cnflicts. If all campers in after care g t the LC, a sign will be psted n the Pavilin dr. Day / Lcatin Mnday Tuesday Wednesday Thursday Friday Early Care Drp ff LC LC LC LC LC Mrning Drp ff TP TP TP TP TP Half Day/ Lunch Pick up TP TP TP TP TP Full Day Pick up TP TP TP TP TP After Care Pick up* TP / LC TP / LC TP / LC TP / LC TP / LC
Page 2 f 2 What t wear t Glf Camp Prper Glf Attire: Applecrss Cuntry Club requires prper glf attire t be wrn n the curse, n the range, and at the Learning Center while participating in all glf activities! Bys must wear a cllared shirt tucked in. Sneakers are acceptable ftwear. Please, abslutely NO t-shirts, tank tps, jeans, gym r carg shrts (external pckets) are permitted n the curse r practice facilities! Sunblck: Please apply sunblck befre camp each day even if it is vercast. Sunblck may be kept in yur camper s glf bag and applied as needed thrughut the day. Full day campers may reapply sunblck at lunch time. It is their respnsibility! Rain Gear / Change f Clthes: Glf is an utdr sprt and may be played in the elements. Camp will g n rain r shine! At times it is pssible campers may experience playing in light rain. We advise packing light weight rain gear r an extra change f clthes in their glf bag as there is always a chance f that unexpected passing summer shwer. Campers will nt cntinue t practice utside if it becmes a heavy dwnpur and/ r lightning ccurs. Things t bring t Glf Camp Glf Clubs: If yur child has their wn glf clubs, they shuld bring them t camp each day. Clubs will nt be stred at the facility vernight. If yur child des nt have clubs, the apprpriate size glf clubs will be prvided fr their use during camp each day. Als, if yu d nt wn clubs, please d nt g and purchase clubs prir t camp. Mst brands f clubs available at the large chain stres are t heavy fr the average junir glfer. If yu later decide t purchase clubs, ur experienced staff can guide yu in chsing the best length and weight f clubs fr yur child. Water Bttles: It is recmmended that all campers have their wn water bttle in rder t stay prperly hydrated during the day. Please make sure his/her full name is written clearly n the bttle. Water bttles can be refilled thrughut the day. If yu frget ne, water is available at varius water clers arund the facility as needed. Lunch/ snacks: Lunch can either be brught in an insulated lunch bag clearly labeled with the campers name r an Applecrss Bx Lunch may be purchased in advance at the time f registratin nly. IMPORTANT: N camper, member r guest, will be permitted t rder lunch frm Tregs Restaurant, therefre, if yu pt t nt purchase the Bx Lunch in advance yu must pack a lunch. Bth Full & Half Day campers shuld als cnsider packing an extra nn-perishable snack (ex: crackers r energy bar) each day t keep in their glf bag that they may eat any time. Additinal Belngings: Campers wh bring an insulated lunch bag, extra clthing r anything ther than their glf bag may leave these items in the TP during the day. These items will nt be supervised. Other things t knw abut Glf Camp Only the primary cntact persn listed n the registratin frm will receive registratin cnfirmatin and camp week reminder e-mails. All campers will receive n curse training. Hwever, we cannt guarantee a specific amunt f time r number f times campers will be able t practice n the curse n any given day r in any given week. Each day and each week f camp ffers a different and unique glf experience. Camp activities change daily frm mrning t afternn as well as week t week and are determined by weather (excessive heat r summer strms) and glf curse availability (tee times, turnaments, curse maintenance, etc.). Full day campers will naturally have mre pprtunity t experience n curse practice. The staff persn with yur child at pickup may nt be the persn wh was with yur child during the day and hence may nt knw f their verall prgress. In additin, true prgress cannt always be measured after just ne r tw days f camp. It may take mre time fr sme fr things t click. Als, if they say they did nthing please d nt assume that is accurate. If yu wish t knw yur child s prgress yu may call Eric MacCluen. All campers (bth members & guests) must stay tgether in their assigned grups and are nt permitted t ram abut the facilities n their wn during the day fr any reasn. If yu have questins pertaining t the glf camp registratin prcess r yu need a receipt fr tax purpses please cntact, Hlly MacCluen at hllymaccluen@yah.cm. Please direct all ther questins r cncerns t the Applecrss Directr f Instructin, Eric MacCluen at 484.888.6611. *Please retain this 2019 Camp Infrmatin Letter fr future reference.