2401 E 3rd Avenue
Foster City, CA 94404
Tel: 650.573.7888
Fax: 650.577.1074

2013 Summer Camp: Online Enrollment
   

Please fill out the forms below to begin your online enrollment. You may add up to three children using this online form.

NOTE: If you wish to pay by phone please call Denise Giordano our camp administrator at (650) 573-7888 ext 223 within 24hrs of submitting your form. You are not officially registered and space cannot be reserved until we receive payment.

Part One: Family Information

Parent's Name:
Address:
City:
Zip:
Home Phone:
Day Phone:
Cell Phone:
Email:
Medical Contact Phone:
Med. Insurance Co:
Medical ID #:

Medical Concerns. Allergies/Medications:


Part Two: Participant(s)' Information

Name of Child
Age
Date of Birth
Camp Date
Session
Registration Fee* ($25, if app.):
Add $25 when registering less than 1 week prior to the start of your camp.
Camp Fee:
   Add Another Child?       Yes       No

TOTAL Camp Fee:
(please calculate)


Part Three: Conditions of Enrollment & Payment Options

Condition of Enrollment


1. I hereby authorize the directors of the Mariners Point Golf Camp to act for me according to their best judgment in any emergency requiring medical attention. I have no knowledge of any physical impairment that would be affected by the above named camper in participation in the camp program. And I hereby waive and release the Mariners Point Golf Camp from any and all liability for any injuries while at camp.

Please print out and complete the Medical/Liability Release Forms for each enrolled child and return them during check-in on the first day of camp. You may fax the forms to (650) 577-1074.

2. The undersigned parent or guardian consents to the use of any pictures of the camper to be used in advertising or promotion.

3. Mariners Point Golf Camp reserves the right to dismiss any player whose conduct is unsatisfactory. There are certain inherent risks associated with golf. A child will be dismissed from a program for compromising the safety of others. Mariners Point Golf Camp is for well adjusted individuals who treat others with respect and value each player's right to a positive camp experience.

4. Camp Cancellations/
Refund Policy:
Cancellations will be given refunds up until June 1st, 2013, less a $100 processing fee. After June 1st, no refunds will be given.

I accept the terms as stated above in Conditions of Enrollment


Part Four: Payment Preference

We accept with full encryption.
Payment Type  
Name on Card  
Credit Card Number  
3-Digit Security Code
(On back of card)
 
Expiration Date  

NOTE: If you would prefer to sumbit payment via phone, you can call call Camp Director, Ron Sagara to submit your credit card information. NUMBER TO CALL: (650) 678-8803