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Cub Creek Science Camp
2013 Registration Form


 

Completion of this form and receipt of your deposit will secure a space for the named camper at Cub Creek Science Camp. 

 

Deposit and camp payment: A $100 per week, non-refundable, non-transferable deposit, is required to secure a place for your child. This deposit is applicable to the total camp fee.

 

The balance of the camp fee is due by April 1, unless you contact us and request an extension.  (click here to see our payment options).  If final payment is not received (and other arrangements have not been made) your deposit will be forfeit and your registration will be cancelled. 

 

Cancellation Policy: For cancellations that occur before May 1st, half the total fee will be returned (less the deposit). No refund is offered if cancellation occurs after May 1st.  Camp tuition insurance is available that will cover your tuition cost if your child is not able to attend camp for any reason.  One company that offers this type of insurance is Travmark.com
Deposit Policy: Deposits are applicable only to the camper for which they are made and may not be transferred or added to another campers tuition. Under no circumstances will the deposit be transferred or refunded should a camper reduce the number of weeks attending.

 

Cub Creek accepts all applicants who are willing to abide by the rules and policies of camp. However, at its sole discretion, we reserve the right to dismiss any camper, without a refund of tuition, whose behavior  does not comply with camp rules or policies or is harmful to themselves or others. .
 

 
Camper Information
Camper's Full Name
Nickname
Gender
Age
Birth date
Grade

(grade completed before camp)
   
Home Address
City
State / Country
Zip
Home phone
   
Parent Information (Parents residing at the same address as the camper)
 
Camper lives with
Fathers Name
Work Phone
Cell Phone
Email Address
Mothers Name
Work Phone
Cell Phone
Email Address
To what e-mail address would you like us to send your confirmation and campers paperwork? 

Place a check next to the session in which you would like to enroll your child.

Sessions

Our programs range from one to six weeks in length.  Campers will choose two new courses for each week at camp and participate in new activities every day.  With over 100 different activities, it would take a camper a minimum of 5 weeks to try everything just once.

Session Age Date      Tuition  Deposit

 

Six Week Program
Weeks 5-10 7 - 17 June 30 - August 10 $4950 $600

 

Four Week Programs
Weeks 5-8 7 - 17 June 30 - July 27 $3300 $400
Weeks 7-10 7 - 17 July 14 - Aug 10 $3300 $400
 

Two Week Programs
Session Age Date Tuition  Deposit
Week 5 & 6 7 - 17 June 30 - 13 $1650 $200
Week 7 & 8 7 - 17 July 14 - July 27 $1650 $200
Week 9 & 10 7 - 17 July 28 - Aug 10 $1590 $200
 

 

One Week Program 

Week 1 7 - 17 June 2 - 8 $825 $100
Week 2 7 - 17 June 9 - June 15 $825 $100
Week 3 7 - 17 June 16 - June 22 $825 $100
Week 4 7 - 17 June 23- June 29 $825 $100

 

 

 

How did you hear about Cub Creek Science Camp?
 If you are a returning camper, may we add your name and phone number to our list of references?   Yes  No
How many years have you attended Cub Creek (including 2012)
What do you love most about camp?  May we quote you?  Yes  No

 

 

Medication Will your child be taking medication while at camp?  If yes, how many times per day?      #x/day 
Cabin Request  Is there anyone this camper would like to share a cabin with ? (Must be within one grade / year of each other)

 
T-Shirt Size A camp T-shirt is included with every registration.  Please indicate your desired size



Person completing this form

 

 

Camp Deposit

 

In order to complete this registration we will need a $100 per week deposit.

 

No space is considered reserved until we have received your deposit.  You will receive a confirmation letter in the mail within two weeks of receipt of your deposit.

 

This deposit is non-refundable and not transferable to a different camper.  You are welcome to switch sessions at any time, as long as we have space.  Your deposit will be applied to your new equal length session.

 

How do you intend to pay your deposit?

I will pay online with my credit card.

I will pay with a check.

I will call the office with my credit card number.

 

We must receive a deposit of $100 per week in order to finalize your request.

 

 

 

 

 

 

Cub Creek Science Camp

Located at Bear River Ranch

16795 Hwy E

Rolla, Missouri  65401

573-458-2125

Director@BearRiverRanch.com