2016 Summer Camp and Weekly Program Registration

2016 Summer Camp and Weekly Program Registration Student Name: ____________________________________________________________ Parent(s) Name: ___________________________________________________________ Address: _________________________________________________________________ City: ________________________________ State: _________

Zip: ________________

Country: _____________________________ Home Phone #: _______________________________ Cell # : ______________________ Parent Cell # _________________________Parent Cell # _________________________ Email Address (Student): ____________________________________________________ Email Address (Parent): _____________________________________________________ Student Date of Birth: _____________ Gender:  M  F

Weekly Summer Camp Prices: Boarding $1,900.00

Non Boarding $1,250.00

Tuition includes six nights’ accommodations, five days of golf and golf instruction (Monday through Friday), personalized fitness program, V-1 video analysis, transportation and all meals for boarding students. For Non boarding students, camps are the same with the exception of lunch being the only provided meal of the day.  Week 1 – May 23 – May 27  Week 3 – June 6 – June 10  Week 5 – June 20 – June 24  Week 7 – July 4 – July 8  Week 9 – July 18 – July 22  Week 11 – Aug 1 – Aug 5  Week 13 – Aug 15 – Aug 19  Week 15 – Aug 29 – Sep 2  Week 17 – Sep 12 – Sep 16

 Week 2 – May 30 – June 3  Week 4 – June 13 – June 17  Week 6 – June 27 – July 1  Week 8 – July 11 – July 15  Week 10 – July 25 – July 29  Week 12 – Aug 8 – Aug 12  Week 14 – Aug 22 – Aug 26  Week 16 – Sep 5 – Sep 9  Week 18 – Sep 19 – Sep 23

Weekly students choose your week*_______________________________  Students who stay for more than one week will receive a 10% discount on additional weeks.

 ½ payment due at registration and the balance is due two weeks prior to the start of camp.  Wiring information can be provided if needed.

HEALTH INFORMATION Please indicate any of the following medical conditions that have been documented by a physician. Problem

(Y/N)

If “YES,” treatment required:

Seizures Asthma Diabetes Allergies Heart Problems Bee Sting Allergies Kidney Disease Hearing Loss Mental/Emotional Problems Hemophilia/Blood Clotting High Blood Pressure Muscle/Bone Weakness Other (Explain)

Are you currently on any medications? _____________ If yes: Medication Name: ______________________ Dosage: ________________________ Condition: _______________________________

PAYMENT Total Payment $_______________ ☐ MC

☐ Check

☐ Money Order

☐ VISA

☐ AMEX

Credit Card Number: ____________________________ Expiration Date: _____________ CVC Code _______________________________________________________________ Name on Card: ___________________________________________________________ Signature of Cardholder: ____________________________________________________

PLEASE RETURN FORM WITH PAYMENT TO COMPLETE REGISTRATION Please scan and email or send by mail to:

GREG NORMAN CHAMPIONS GOLF ACADEMY AT BAREFOOT RESORT 2051 ACADEMY WAY, NORTH MYRTLE BEACH, SC, 29582 PHONE: 843.399.1551 [email protected]

Cancellation Policy: Applications fees and deposits are non-refundable. For campers who have applied to a program but cannot attend for any reason, you may select an alternative program session, subject to availability and according to the following terms: o o o o o o

Notice of transfer must be submitted in writing by email to [email protected]. No prorated credits will be issued for partial attendance at a program session or missed days due to illness, dismissal, behavioral issues, or any other reason. All alternative program session requests must be received no later than two (2) weeks prior to the start date of earliest scheduled program session. The alternative program session request must be redeemed by the conclusion of the 2016 summer program sessions; otherwise all amounts paid are forfeited. In the event the alternative program session is more expensive than the session originally paid for, the camper/ camper’s guardian shall pay the difference in program fees. The Obligor grants CGA permission to use the name of the Student and any photos of the Student in any brochures, videos, and/or any other promotional material generated by CGA.

GNCGA reserves the right to cancel a program session if participation numbers are not adequate. You may select an alternative program session date or request a full refund of amount paid. GNCGA is not responsible for any personal travel or other expenses associated with attending the program session. Camper waives any and all damages that may otherwise arise out of any camp cancellation and agrees to accept as liquidated damages the refund of said camp tuition fees.