Please print clearly and complete a separate registration form for each camper . All campers must submit the All Camps Registration Form and Payment Form along with this registration .
Child ’ s Name :________________________________________ Birthdate :___________________ Grade ( Fall ‘ 17 ):________ ���Member ���Non-Member
{
Week 6 : July 24 - 28 Week 7 : July 31 - August 4 Week 8 : August 7 - 11
Grades K-8 9:00 a . m . - 3:30 p . m .
� Week 6 � Week 7 � Week 8
$ 325 M / $ 375 NM $ 325 M / $ 375 NM $ 325 M / $ 375 NM
We are pleased to offer this opportunity . However , there are limited spaces available and in order to accommodate the most campers , enrollment is limited to two weeks . A fifty percent deposit is required with this registration . The deposit will be refunded if your child is not selected for Voices Together . If your child is selected the balance must be paid in full by June 2 , 2017 . Fees may be charged on MasterCard , American Express or Visa or paid by Electronic Funds Transfer ( EFT ). There will be no refunds after June 16 , 2017 .
Peer Camper Application
( no fees apply )
Peer campers must also complete the All Camps Registration Form ( page 25 )
To be considered for this program , peer campers should be in the 8th grade or higher . When the camp is full , peer camper applicants will be placed on a waiting list .
Select which weeks you are interested in as a peer camper : ��July 24 - 28 ��July 31 - August 4 ��August 7 – 11
Please list your experience working with children with Autism :___________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________
Please describe your interest in working at Voices Together :_____________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________
Important things to bring to camp : Smile , promptness , flexibility , patience , hearty lunch , bathing suit / towel and lots of energy !
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Fax or Mail your Peer Camper Application to :
Melissa Bunce , Weinstein JCC Director of Inclusion and Support Services 5403 Monument Avenue • Richmond , VA 23226 • Phone : ( 804 ) 545-8658 • Fax ( 804 ) 285-3139