*Enchantment Camps*2010 Registration Form*

For more information, call 985-1124    or e-mail  jalisonjames-at-yahoo.com

Registering for (circle which camp or camps)

call if you would like to be put on the wait-list

Lower School ages 8-12
[Animagic   June 28 – July 2]   full
[Magicology    July 12-16]   full

Upper School ages 10-15

Magicology   July 26-30 full

Animagic  August 9-13

Student’s Name__________________________________________________

Date of Birth_____________     Grade as of 9/10 ____    Male __  Female __

Contact Parent/guardian name ______________________________________________________________
Relationship to magician: ____________________________________________________________________

Address: __________________________________________________________________________________

Phone (home) __________________________  work__________________________ cell _________________

e-mail address ______________________________________________________________________________

Second parent / guardian name: ______________________________________________________________

Relationship to magician: ____________________________________________________________________

Address: __________________________________________________________________________________

Phone (home) __________________________  work__________________________ cell _________________

e-mail address ______________________________________________________________________________

___ I give Enchantment Camps permission to reproduce photos or video in which my child appears.

___  I give Enchantment Camps permission for the contacts listed below to pick-up my son/daughter.

Please list two additional contacts in case of an emergency if you cannot be reached:

Name: ___________________________________                  Phone: __________________________

Relationship: _____________________________                 Cell: _____________________________

Name: ___________________________________                  Phone: __________________________

Relationship: _____________________________                 Cell: _____________________________

Health note: If your child has any allergies, food preferences, or other health concerns,
please attach a sheet with the information. Please include your doctor’s name and phone number.

“I understand fully that even after responsible precautions have been taken, camp activities may involve hazards
for which Enchantment Camps cannot be held responsible. In the event that my child becomes ill or injured during
class, I authorize staff to seek emergency care. In signing below, I certify that my child is covered by health and
accident insurance or Medicaid and that in the unlikely case of an accident, I will provide Enchantment Camps
 with the name of the carrier and the policy number.”

Signature (Parent/Guardian) _____________________________________________ Date ______________

Camp Fees: $285       Deposit per camp to hold your space $100.   All tuition due June 1st.

Snacks provided; please pack healthy lunches

Robes and wand required. Robe $25; Wand $10. Notify asap if needed.

Camp runs from 9am - 3:30 After-care to 5pm available for $10/day.
You can sign up and pay for aftercare that morning

Please enclose  $100 Deposit per camp, Robe & Wand costs:  deposit refundable before 4/15 less $25 fee

                                                                                                amount enclosed       $________

full tuition due after 6/1                                                                         amount due $________

mail to: Enchantment Camps

Joplin and Alison James

338 Thompson Road

Shelburne, Vermont  05482