TCA REGISTRATION SUMMER 2008
On-Line Registration Form

Thank you for choosing TCA's On-Line Registration.
Please complete ONE Registration Form for EACH Teen attending.

TRAVELER'S INFORMATION
TEEN's LAST NAME
TEEN's FIRST NAME
MAILING ADDRESS
CITY
STATE
ZIP/POSTAL CODE
 COUNTRY
DATE OF BIRTH   mm/dd/yy
AGE UPON ARRIVAL
AT CAMP
US Citizens Only
used for Medical Purposes Only
SOCIAL SECURITY NUMBER
SEX
BOY GIRL
PARENT'S NAME(s)
CHILD LIVES WITH
(ie. Mother and Father, Father, Mother, Father and Step-Mother, Father and Step-Mother, Grandparents)
FATHER'S NAME
MOTHER'S NAME
FATHER'S
HOME PHONE NUMBER
MOTHER'S
HOME PHONE NUMBER
FATHER'S
WORK PHONE NUMBER
MOTHER'S
WORK PHONE NUMBER
FATHER'S
CELL PHONE NUMBER
MOTHER'S
CELL PHONE NUMBER
FATHER'S
eMAIL ADDRESS
MOTHER'S
eMAIL ADDRESS

Please provide any information which will assist us in providing a
great experience for your child. (Do not provide medical information here.)
TCA 2008 Registration
PAYMENT OPTIONS

PAYMENT IN FULL of $ 3,850.00
DEPOSIT of $850.00
and 6 monthly payments of $ 500.00
ADDITIONAL AIRPORT FEES

AIRPORT TRANSPORTATION
Pick-Up Camper FROM the
Tampa International Airport		 $50

Bring Camper TO the
Tampa International Airport

 $50
AVAILABLE DISCOUNTS

2008 FAMILY DISCOUNT

$100 Family Discount for more than one child attending from the same household. All children after the first are eligable.
PLEASE PROVIDE PAYMENT INFORMATION
NAME as it appears on your Credit Card
E-MAIL ADDRESS of the Card Holder
STREET ADDRESS
to which your Credit Card is billed
TELEPHONE NUMBER
CITY to which your Credit Card is billed
ZIP/POSTAL CODE
to which your Credit Card is billed
STATE OR PROVINCE
 COUNTRY

Unfortunately, our web software does not total up your tuition automatically.
Please calculate the above options and enter the amount here. Remember to take all applicable discounts.

I authorize the following charges to my credit card.
TOTAL PAYMENT AT THIS TIME $

Your Credit Card Number
Card Verification Value

What is this?
Expiration Date
Month
Year
Select the type of Credit Card
Visa
(We are not able to accept Discover)
Any comments relating to your payment

 2008 REGISTRATION AGREEMENT
 
I/We have read and understand the terms,  policies and requirements of  attending TCA and understand that signing this agreement confirms compliance. I/We give complete authorization for a representative of the TCA Staff to request and receive any medical treatment in the event of need.  I/We accept full responsibility for the payment of all medical services provided. I/We release and hold blameless the employees, volunteers, and Board of Directors of Camp Frontier, Inc. from any and all claims of liability past, present and/or future. I/We accept the financial responsibility for any and all damage to facilities or personal property for which our Child is found to be responsible. I/We acknowledge that Camp Frontier, Inc. owns and has discretion over the use of  all photographs and recordings created while the Child participating. I/We understand that the Tuition balance is due thirty days prior to the start of the program. I/We authorize the balance due, if any, to be charged to the provided credit card thirty day prior to arrival. I/We understand that any and all deposits, fees and or tuition amount paid is non-refundable even should the child not attend, go home during the program or be expelled due to dishonest, disrespectful or violent behavior.

 Please Type Your Name To Accept The Terms Of Enrollment  (required)
 


PLEASE SUBMIT ONLY ONCE.
Press  and your Registration Form will be processed
or  to erase and start again.

THANK YOU!