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2024 San Mateo County 4-H Summer Camp Registration and Payment Method

San Mateo County 4-H Summer Camp Registration and Payment Method

Theme: Camp Outback

Sunday, July 21 to Friday, July 26, 2024

Please read and follow the camp registration instructions carefully.

Camp is filled on a first-come, first-served basis. Please be sure to complete registration and payment (we are accepting a deposit to hold your spot). Once the camp maximum has been reached, a waitlist will be started.

You will be considered registered when the following items are completed/submitted by the Thursday, June 13, 2024 Deadline. If your child's application is not complete by the deadline, their registration will be moved to the waitlist.

Each camper will need to complete a registration separately.

Please download these forms before you start the registration process:

4-H Camp Rules
YMCA San Francisco - Release & Waiver of Liability & Indemnity Agreement (Spanish version here)

You will need to sign and upload the forms at the bottom of this regsitration.

If you are unable to scan the forms (pdf) and upload, please mail the form to this address:

ATTN: 4-H Summer Camp

1500 Purisima Creek Rd.

Half Moon Bay, CA 94019

Camp Registration Steps

Complete Camp Registration (submitted through this registration form).
ZSuite (must be enrolled in 2023-2024 program year) - Do not create a new profile if you enrolled last year! Refer toNew Member Enrollment OR Returning Member Enrollment
4-H Fee is $67 (if not currently enrolled in the 2023-2024 program year) - payment of 4-H fees is included in the camp registration below.
Sign and upload 4-H Camp Rules.
Sign and upload YMCA San Francisco - Release & Waiver of Liability & Indemnity Agreement (Spanish version here)
Total Fees: credit card payments are accepted at the end of this registration form.

✻ = Required

Camper Registration Information

Camper's First Name: ✻

Camper's Last Name: ✻

Parent's E-mail (one you check often): ✻

Camper's 4-H Age (by December 31, 2023): ✻

Camper's grade completed 2024: ✻

Camper's Gender Identity: ✻

Female Male Nonbinary Gender not listed

Camper's T-Shirt Size: ✻

Child Large Adult Small Adult Medium Adult Large Adult XL Adult XXL

Parent/Guardian/Payor Information

Parent/Guardian/Payee First Name: ✻

Parent/Guardian/Payee Last Name: ✻

Parent's Contact Phone # (format XXX-XXX-XXXX): ✻

Would the parent/guardian be interested in being a camp chaperone?

Yes No

Camper Information

Information collected here will help with cabin assignments.

Camper's Birthdate (MM/DD/YYYY): ✻

Name of School: ✻

Type of School: ✻

Public Private Charter Home

If you are enrolled in another 4-H County, please enter the county:

Have you attended the San Mateo County 4-H Summer Camp before? ✻

Yes No

How many years have you attended 4-H Camp (enter 0, if you have never attended)? ✻

Cabin assignments are made by gender identity.

Do you have a request of who you would like to share a cabin with?

*Please keep in mind that staff works extremely hard to meet all cabin requests, but all requests may not be guaranteed. Maximum of three requests only please. We will only consider the first three names entered.

For the Camp Kitchen: Does the camper have any dietary restrictions, food allergies, etc. Please list or enter n/a. ✻

Does your child require any accommodations to participate in camp? If yes, please provide any guiding information for our camp staff. ✻

Does your child have any physical, emotional, or mental health conditions that the camp nurse should be made aware of? ✻

Is there anything about your child that would be helpful for us to know? (i.e., First time away from home, does not want to be in a cabin with big sister, preferred pronouns, arriving late, etc.) ✻

What concerns, if any, does your child have about attending camp? ✻

What suggestions do you have on how to handle your child's concerns? ✻

EMERGENCY CONTACT

Person should be local (within 2.5 hrs or less driving distance from the camp location) and NOT the parent/guardian listed above.

Emergency Contact (First and Last Name): ✻

Relationship to camper: ✻

Emergency Contact Phone Number (XXX-XXX-XXXX) ✻

PAYMENT

There are two payment options:

Pay in full with the camper registration.
Pay a $150.00 deposit with the camper registration and pay the remaining balance by June 13. 2024. A link will be sent to you to complete the remaining payment.

Refund Policy: You will receive a full refund of the camper registration fee or camper deposit fee if you request it in writing (email) before June 13, 2024. Email to smsf4h@ucanr.edu.

4-H Enrollment fees are non-refundable ✻

Agree

Payment Information

Current 4-H Member Camp Fee	$ 675.00
Newly Enrolling 4-H Member Camp Fee Includes 4-H Enrollment Fee	$ 745.00
Registration Deposit - Balance will be billed and due by June 13, 2024	$ 150.00

Please select the appropriate payment amount below

FULL Camp Fee (Current 4-H member) - Credit Card

$675.00

FULL Camp Fee (Not Current 4-H member) - Credit Card
(includes $70.00 4-H enrollment fee)

Please refer to this attachment for the Steps to enroll as a NEW 4-H member.

$745.00

Partial Payment Camp fee deposit:

Balance will be billed and due by June 13, 2024

$150.00

CAMP STAFF ONLY:

Is this youth participating as a member of camp youth staff?

Please see Allan Bruce for payment options.

YES NO

Continue to the next screen after submitting registration.

You will begin the process for entering your credit card information.

If you are having trouble with credit card processing, please view this Credit Card Processing Help Guide.

Please remember to upload the signed PDF versions of 4-H Camp Rule and YMCA San Francisco - Release & Waiver of Liability & Indemnity Agreement (Spanish version here)

Upload your file(s)

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