2019 Evergreen Summer Camp Waiting List
Regular registration is now closed. However, you can still register and be placed on the wait list and if there are cancellations, you will be given a spot according to the waitlist order.
We will start notifying you if there are spots open on April 2nd.
If you have any question, please contact at camp@nyevergreen.com or 516-822-6900.
Thank you!

www.nyevergreen.com/summer-camp
https://www.facebook.com/nyevergreencamp

Email address *
REGISTRATION FORM
6/28/2019 - 8/9/2019 (MON to FRI)
8:30 am to 3:00 pm

Important Dates:
March 2 - Open House (10 am- 11 am)
June 28- First Day of Camp
July 4th- July 5th- Camp Closed for 4th of July
August 9- Last Day of Camp

If you have any question, please contact at camp@nyevergreen.com or 516-822-6900.

First Child
Required
Child's Name *
First and last name
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Grade *
Entering in Sept.
Your answer
Gender
Current School
Your answer
The 1st Child T-shirt size *
Second Child
Optional
Child's Name
First and last name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Grade
Entering in Sept.
Your answer
Gender
Current School
Your answer
The 2nd Child T-shirt size
Third Child
Optional
Child's Name
First and last name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Grade
Entering in Sept.
Your answer
Gender
Current School
Your answer
The 3rd Child T-shirt size
Parent/Guardian Information
Home Address
Your answer
Parent's (Guardian) Name *
First and last name
Your answer
Parent's (Guardian) Cell # *
Your answer
Primary Emergency Contact #
Your answer
Secondary Emergency Contact #
Your answer
Parent (Guardian) Email Address *
Your answer
Child Allergies
Please be specific:
Your answer
How did you hear about us?
Payment & Refund Policy
*** 6 WEEKS: $1,200
*** Early Bird Special: $1,100 (3/2-3/31)
* Trip fees not included

The last day for the early-bird discount will be MARCH 31st.
A $100 DEPOSIT is required.
FULL TUITION must be submitted by MAY 1st to secure your child's spot at our camp.
NO REFUND or CREDIT starting June 1st.
* Check payable to: Evergreen Church
* Address: 20 Andrews Road, Hicksville, NY 11801

To ensure a low teacher-to-camper ratio, we will only accept a limited number of campers. So hurry and register now before the camp is filled!

3/2 ~ 3/31 Early-bird registration ($100 deposit)
4/1~4/30 Regular registration ($100 deposit)
5/1 Full Tuition must be submitted
5/1 ~ 5/31 Full refund available
6/1 ~ No refund, or credit given

After you submit, we will contact you soon. Thank you!
If you have any question, please contact at camp@nyevergreen.com or 516-822-6900.
A copy of your responses will be emailed to the address you provided.
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