REGISTRATION FORM FOR Summer Immersion Camp 2008

Immersion Camp Tuition is $195.00 per week. This includes all materials and snacks. 10% discount for multiple weeks/family members.

Student Name:_________________________________________________

Address:_________________________________________(City, State, Zip)

Parent Name : _________________________________________________

Daytime telephone :______________________________________________

Cell phone: __________________ Email Address:______________________

Student Age: ________________ Birth Date: __________________________

School/ Grade attending in Sept. 2008:________________________________

Food Alergies or special needs?_____________________________________

_____________________________________________________________

Please register my daughter/son (name)  _______________________for: 

                      French   ~   Spanish   ~   World Cultures
                      July 7-11                July 14-18                     July 21-25  

                                 ~Circle Choices Above~  

Parent signature:__________________________________

Today’s Date:____________________________________

Enclosed is my $50.00 non-refundable deposit.  I understand the balance is to be paid in full by June 5, 2008. Once tuition is paid in full there will be no refunds. Enrollment is limited to 14 students per session.

Please mail this form and your deposit to:

CHERYL BERMAN
40 ALEHSON ST.
RYE, NH 03870-2003

Cheryl P. Berman ~ www.CherylBerman.com
Email: CherylPBerman@aol.com