EmailMe Form - PSN Winter Break Camp 2023/24

PARENTS INFORMATION
Mothers Name *
Fathers Name *
Cell Phone Number #1 *
### - ### - ####
Cell Phone Number #2
### - ### - ####
Email #1 *
Email #2
CAMPER(S)
How Many Children are you Registering? *
CHILD #1 INFORMATION
#1: Child's Full Name *
#1: Date of Birth *
#1: Will your Child participate in only the ALM Camp, Specialized Sports Training or Both *
#1: What Specialized Sport will your Child Play?
CHILD #2 INFORMATION
#2: Child's Full Name
#2: Date of Birth
#2: Will your Second Child participate in only the ALM Camp, Specialized Sports Training or Both
#2: if applicable: What Specialized Sport will your Second Child Play?
CHILD #3 INFORMATION
#3: Child's Full Name
#3: Date of Birth
#3: Will your Third Child participate in only the ALM Camp, Specialized Sports Training or Both
#3: if applicable: What Specialized Sport will your Third Child Play?
PROGRAM & PAYMENTS
What ALM Camp Days will your First Child be Participating in?
1 Child: ALM Camp & Specialized Sports - All 7 days (7:30am-6pm) ($220)
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1 Child: ALM Camp Only 7 Days (7:30am-6pm) ($150)
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1 Child: Specialized Sports Only 7 days (10am-3pm) ($150)
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-- Check the Daily Rates Below --
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1 Child: Wednesday Dec 27th - Only ALM Camp (7:30am-6pm) ($35)
1 Child: Wednesday Dec 27th - Only Specialized Sports (10am-3pm) ($35)
1 Child: Wednesday Dec 27th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($50)
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1 Child: Thursday Dec 28th - Only ALM Camp (7:30am-6pm) ($35)
1 Child: Thursday Dec 28th - Only Specialized Sports (10am-3pm) ($35)
1 Child: Thursday Dec 28th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($50)
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1 Child: Friday Dec 29th - Only ALM Camp (7:30am-6pm) ($35)
1 Child: Friday Dec 29th - Only Specialized Sports (10am-3pm) ($35)
1 Child: Friday Dec 29th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($50)
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1 Child: Tuesday Jan 2nd - Only ALM Camp (7:30am-6pm) ($35)
1 Child: Tuesday Jan 2nd - Only Specialized Sports (10am-3pm) ($35)
1 Child: Tuesday Jan 2nd - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($50)
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1 Child: Wednesday Jan 3rd - Only ALM Camp (7:30am-6pm) ($35)
1 Child: Wednesday Jan 3rd - Only Specialized Sports (10am-3pm) ($35)
1 Child: Wednesday Jan 3rd - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($50)
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1 Child: Thursday Jan 4th - Only ALM Camp (7:30am-6pm) ($35)
1 Child: Thursday Jan 4th - Only Specialized Sports (10am-3pm) ($35)
1 Child: Thursday Jan 4th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($50)
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1 Child: Friday Jan 5th - Only ALM Camp (7:30am-6pm) ($35)
1 Child: Friday Jan 5th - Only Specialized Sports (10am-3pm) ($35)
1 Child: Friday Jan 5th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($50)
#1: You Save: $80 if you choose 7 days for ALM Camps & Specialized Sports

#2: For the Daily Rates you can combine both ALM Only & Specialized Sports for the Full day (7:30am-6:00pm)
What ALM Camp Days will your Second Child be Participating in?
2nd Child: ALM Camp & Specialized Sports - All 7 days ($210)
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2nd Child: ALM Camp Only 7 Days ($140)
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2nd Child: Specialized Sports Only 7 days ($140)
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-- Check the Daily Rates Below --
--
2nd Child: Wednesday Dec 27th - Only ALM Camp (7:30am-6pm) ($30)
2nd Child: Wednesday Dec 27th - Only Specialized Sports (10am-3pm) ($30)
2nd Child: Wednesday Dec 27th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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2nd Child: Thursday Dec 28th - Only ALM Camp (7:30am-6pm) ($30)
2nd Child: Thursday Dec 28th - Only Specialized Sports (10am-3pm) ($30)
2nd Child: Thursday Dec 28th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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2nd Child: Friday Dec 29th - Only ALM Camp (7:30am-6pm) ($30)
2nd Child: Friday Dec 29th - Only Specialized Sports (10am-3pm) ($30)
2nd Child: Friday Dec 29th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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2nd Child: Tuesday Jan 2nd - Only ALM Camp (7:30am-6pm) ($30)
2nd Child: Tuesday Jan 2nd - Only Specialized Sports (10am-3pm) ($30)
2nd Child: Tuesday Jan 2nd - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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2nd Child: Wednesday Jan 3rd - Only ALM Camp (7:30am-6pm) ($30)
2nd Child: Wednesday Jan 3rd - Only Specialized Sports (10am-3pm) ($30)
2nd Child: Wednesday Jan 3rd - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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2nd Child: Thursday Jan 4th - Only ALM Camp (7:30am-6pm) ($30)
2nd Child: Thursday Jan 4th - Only Specialized Sports (10am-3pm) ($30)
2nd Child: Thursday Jan 4th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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2nd Child: Friday Jan 5th - Only ALM Camp (7:30am-6pm) ($30)
2nd Child: Friday Jan 5th - Only Specialized Sports (10am-3pm) ($30)
2nd Child: Friday Jan 5th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
#1: You Save: $150 if you choose 7 days for ALM Camps & Specialized Sports

#2: For the Daily Rates you can combine both ALM Only & Specialized Sports for the Full day (7:30am-6:00pm)
What ALM Camp Days will your Third Child be Participating in?
3rd Child: ALM Camp & Specialized Sports - All 7 days ($210)
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3rd Child: ALM Camp Only 7 Days ($140)
------
3rd Child: Specialized Sports Only 7 days ($140)
------
-- Check the Daily Rates Below --
--
3rd Child: Wednesday Dec 27th - Only ALM Camp (7:30am-6pm) ($30)
3rd Child: Wednesday Dec 27th - Only Specialized Sports (10am-3pm) ($30)
3rd Child: Wednesday Dec 27th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
--
3rd Child: Thursday Dec 28th - Only ALM Camp (7:30am-6pm) ($30)
3rd Child: Thursday Dec 28th - Only Specialized Sports (10am-3pm) ($30)
3rd Child: Thursday Dec 28th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
--
3rd Child: Friday Dec 29th - Only ALM Camp (7:30am-6pm) ($30)
3rd Child: Friday Dec 29th - Only Specialized Sports (10am-3pm) ($30)
3rd Child: Friday Dec 29th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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3rd Child: Tuesday Jan 2nd - Only ALM Camp (7:30am-6pm) ($30)
3rd Child: Tuesday Jan 2nd - Only Specialized Sports (10am-3pm) ($30)
3rd Child: Tuesday Jan 2nd - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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3rd Child: Wednesday Jan 3rd - Only ALM Camp (7:30am-6pm) ($30)
3rdChild: Wednesday Jan 3rd - Only Specialized Sports (10am-3pm) ($30)
3rd Child: Wednesday Jan 3rd - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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3rd Child: Thursday Jan 4th - Only ALM Camp (7:30am-6pm) ($30)
3rd Child: Thursday Jan 4th - Only Specialized Sports (10am-3pm) ($30)
3rd Child: Thursday Jan 4th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
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3rd Child: Friday Jan 5th - Only ALM Camp (7:30am-6pm) ($30)
3rd Child: Friday Jan 5th - Only Specialized Sports (10am-3pm) ($30)
3rd Child: Friday Jan 5th - Combined ALM Camp & Specialized Sports (7:30am-6pm) ($45)
#1: You Save: $220 if you choose 7 days for ALM Camps & Specialized Sports

#2: For the Daily Rates you can combine both ALM Only & Specialized Sports for the Full day (7:30am-6:00pm)
INSURANCE
Does your Family need our Insurance? *
$0 if you have your insurance as a Primary
$10 for the 7 days for our partnered ALM Insurance as a primary at PSN Park
Primary Insurance Details
(your childs insurance carrier and policy number)
Please list the people that will collect your child at the end of the day. *
(Name / Phone number / Relation to your child)
PLEASE NOTE: the above listed people will need to provide ID
Medical Concerns
Food Allergies
REFERRALS
How did you hear about this Camp?
Be sure to let Others know about the Camp
TERMS & CONDITIONS
I have read and agree to the Terms of Service *
Yes, I agree.
If your child is covered by a private insurance, you must provide us with proof of your child’s insurance coverage. If your child is not We offer this through our Partners ALM Sports Insurers at a cost of $10.00 for up to 7 days during the Winter Break camp. I give consent for my child to take part in the activity and consent to emergency treatment as necessary. I accept that the organizers and their employees are not under any liability whatsoever in respect of injury, loss or damage whilst on the course, other than imposed by law. I also allow ALM to take photos for advertising and promoting purposes only; if you do not want your child's photo to be taken please email almsportsteam@gmail.com. I confirm that my personal insurance is correct and bears responsibility in case of accidents. I confirm that I am legally entitled to give this consent and understand all payments received are non-refundable.
I agree and understand that all payments are non-refundable *
Yes, I agree.

PARENTS INFORMATION

CAMPER(S)

CHILD #1 INFORMATION

CHILD #2 INFORMATION

CHILD #3 INFORMATION

PROGRAM & PAYMENTS

INSURANCE

REFERRALS

TERMS & CONDITIONS