19767 Yorba Linda Blvd.
Phone: (714) 970-2771 • Fax: (714) 970-5654
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US IN THE SON
Summer Day Camp Online Registration Form
St. Martin's Church
19767 Yorba Linda Blvd
Yorba Linda, CA 92886
(714) 970-2521
Day Camp
$125.00 per child per week
T-shirt Size (check)
S (6-8)
M (10-12)
L (14-16)
Adult Small
Camper's Last Name
First
MI
Age
Sex
Grade (in fall)
Address
City
Zip
Home Phone
Emergency Phone
Birthdate
Living With
(Check all that apply):
Both Parents
Father
Mother
Brother
Sister
Relative
Father's Full Name
Work Phone
Mother's Full Name
Work Phone
Beach Trip
Yes
No
Park Trip
Yes
No
Session Preference:
Check the week(s) you would like your child to attend.
Session 1:
July 5-9
Session 2:
July 12-16
Session 3:
July 26-30
Session 4:
August 9-13
Day care will be offered at all sessions. Extra fee applies.
Day Care
Morning (7:30am - 9:45am) Cost: $25
Afternoon (4:00pm - 5:30pm) Cost: $25
All Day Cost: $50
Please note: Only day care fees are applicable for tax write offs.
Special Requests (If necessary, write requests for campers who want to be in the same group):
***There is a $25.00 non-refundable deposit included in the registration fee.
Please print this page if you would like to have a copy for your records.
When you click on SUBMIT, the registration form will be sent to the US IN THE SON director to enroll the child in the day camp program. You will also be taken to the parish credit card system to pay for the program.
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19767 Yorba Linda Blvd., Yorba Linda, CA 92886, (714) 970-2771
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