NVCSA Cue Camp Family Registration

2007 Registration Fee Schedules:

A deposit of $50 must accompany the registration form with the balance due upon arrival at the 4-H Center. Registration forms post-marked after September 20th, and on-line registrations submitted after September 23rd, must include a $10.00 late charge. We cannot accept family overnight camper registrations after Saturday, September 23rd. Please honor these deadlines!

Camp rates are all-inclusive. The fee covers all meals, lodging, classes, babysitting (for Beginning CS parents on Sunday morning), presentations and programmed social activities for all family members.

Cue Camp Overnight Camper Fee Scale (for members of the same family)

1 person	$150	4 people	$375
2 people	$240	5 people	$435
3 people	$315	6 or more	$500
College student fee: $100 (indicate College in Grade Section below) Children 3 years old and younger are free!

Cue Camp Day Camper Fee Scale

Day rates are inclusive of all activities but do not include lodging. Rates are per person. Children 3 years old and younger are free!

1 day - Friday or Saturday day only (3 meals and all activities)	$60 per day
2 days - Friday and Saturday day only (6 meals and all activites)	$95 both days
3 days - Fri., Sat. and Sunday, day only (7 meals and all activities) (persons enrolled in the beginning cue class who stay off site.)	$105 three days

For more than two family members, per person rates. Children 3 years old and younger are free!

1 day - Friday or Saturday day only (3 meals and all activities)	$45 per person
2 days - Friday and Saturday day only (6 meals and all activities)	$70 both days, per person
3 days - Fri., Sat. and Sunday, day only (7 meals and all activities) (persons enrolled in the beginning cue class who stay off site.)	$80 three days, per person

Current members of the Northern Virginia Cued Speech Association will receive one free tee shirt when they sign in at camp, so don't forget to renew your membership!

Last Name
Address
City
State
Zip Code
Daytime Phone
Evening Phone
E-mail (required field)
Please complete a line below for each person attending. Class Level Codes: B=Beginner A=Adv. Beg./Int. C=Children T=CLT P=Professional U= College Student Please complete a line below for each person attending. Please include the person listed above.

Participant Name	Birth Date if under 18	Grade in School	Class Level See codes above	Deaf/ HOH check if yes	If d/hoh, check primary mode
					CS Oral Sign
					CS Oral Sign
					CS Oral Sign
					CS Oral Sign
					CS Oral Sign
					CS Oral Sign
					CS Oral Sign
					CS Oral Sign


Check if Needed:	Transliterator *Sign Language Interpreter Ramp Access If a sign language interpreter is required, please contact us by relay, mail, or email NVCSA@yahoo.com no later than September 20th.**
List preferred roommates, if desired:
Check if yes	Do you want to stay in an "adults only" cabin?
Check if yes	I am paying by PayPal. (Your registration will not be processed until your funds have been received.) If you are not paying by PayPal please use our printable form and mail the completed form with your payment. Credit cards can only be processed through PayPal.

Total Number of Family Members Attending (includes those in college and under 3 years old)

Total Camp Fees $

I would like to make a donation to NVCSA in the following amount
in order to help sponsor Cue Camp Virginia activities and families. $

I would like to pay my NVCSA Annual Dues of $20.00

Total Due to NVCSA $

Current Payment $ ($50.00 minimum deposit required, $70.00 minimum if also paying dues.)

Balance is due at check in.

Remember we cannot process your application until you make your payment through PayPal!