1 YOUNG WRITERS CAMP APPLICATION DUE MAY 30, 2017 We are excited you want to join us for Young Writers Camp 2017! Writers of all skill levels are welcome. The only requirement is to attend camp each day, participate in writing activities, and maintain a positive, respectful attitude throughout. NOTE: You must complete a SEPARATE application for EACH student. Your child s spot in camp will not be reserved until this application and payment have been received. FIRST CAMP LOCATION Select the grade your child will enter in SEPTEMBER 2017 under the camp location you want. This year we are offering our first 1st - 2nd grade camp at Franklin Elementary in Santa Barbara, and the upper grade Playwriting Workshop and Digital Writing Camp return! Also, as a special deal, we have discounted pricing for campers who would like to attend any two sessions of camp (see details in CAMP FEE section on page 4). 1. Franklin Elementary School, July 17-29 (Mon-Fri, 8:00 a.m. - 12:30 p.m.) Grades 1-2 2. UCSB Creative Writing Morning Session 1, June 19-30 (Mon-Fri, 9:00 a.m. 12:30 p.m.) Grades 3-4 Grades 5-6 Grades 7-9 3. UCSB Creative Writing Afternoon Session 1, June 19-30 (Mon-Fri, 1:00 4:30 p.m.) Grades 3-4 Grades 5-6 Grades 7-9 4. UCSB Playwriting Workshop Session 2, July 10-27 (Mon-Thurs, 1:00 p.m. 4:00 p.m.) Grades 7-12 5. UCSB Creative Writing Morning Session 2, July 10-21 (Mon-Fri, 9:00 a.m. 12:30 p.m.) Grades 3-4 Grades 5-6 Grades 7-9 6. UCSB Digital Writing Morning Session 2, July 10-21 (Mon-Fri, 9:00 a.m. 12:30 p.m.) Grades 7-9 7. UCSB Digital Writing Afternoon Session 2, July 10-21 (Mon-Fri, 1:00 p.m. 4:30 p.m.) Grades 7-9 8. Cal Lutheran University, Thousand Oaks July 10-21 (Mon-Fri, 9:00 a.m. 12:30 p.m.) Grades 3-4 Grades 5-6 Grades 7-9 9. Jonata Middle School, Buellton, June 19-30 (Mon-Fri, 9:00 a.m. 12:30 p.m.) Grades 4-6 Grades 7-9
2 SECOND STUDENT INFORMATION 1. Student Name 2. Date of Birth Male Female 3. School in Sept. 2017 4. Grade in Sept. 2017 5. T-Shirt Size: Child Small Child Medium Child Large Adult Small Adult Medium Adult Large 6. Parent Name 7. Language Preference: English Spanish 8. Street Address City Zip 9. Best Contact Phone 10. Email Address 11. Share any special educational/emotional needs your child has: B. Emergency contact & health information: 1. Name of Emergency Contact 2. Phone Number 3. Child s Physician 4. Physician s Phone 5. Allergies, if any 6. List any medical problems or special needs that our staff needs to know about: THIRD PARENT AUTHORIZATION, PHOTO AUTHORIZATION & WAIVER OF LIABILITY PARENT AUTHORIZATION FOR YWC I give permission for Young Writers Camp at South Coast Writing Project to use my child s writing, drawings and photographs in various professional presentations and/or publications. PARENT SIGNATURE X DATE WAIVER OF LIABILITY FOR UCSB IMPORTANT: You MUST complete all of the following on the bottom of the next page: Child signature, FULL name, Date of signing, Age Parent signature, FULL name, Date of signing
3 FOURTH For STUDENT to complete A. Circle one: a. I love to write! b. I like writing and it is pretty easy for me. c. I like writing but it is hard for me. d. I don t really like to write, but I want to get better. B. Why do you want to come to Young Writers Camp this summer? For PARENT to complete C. Please tell us briefly what you are hoping your student will get out of Young Writers Camp.
4 FIFTH CAMP FEE Payment must be made by check, cash, or money order; we are unable to accept credit card payments. If enrolling multiple students, a single check or money order can be used. Early Bird Registration (March 8- April 30, 2017): 1 camper: $275 2 campers: $530 3 campers: $796 4 campers: $1,062 Regular Registration (May 1- May 30, 2017): 1 camper: $295 2 campers: $543 3 campers: $814 4 campers: $1,086 Late Registration (Any applications received after May 30, 2017) 1 camper: $315 2 campers: $600 3 campers: $885 4 campers: $1,170 Students registering for any TWO camps or camp sessions 1 camper: $530 2 campers: $1,060 3 campers: $1,590 4 campers: $2,120 Group Registration (only available to districts, schools, PTAs and other school groups/nonprofits that contact SCWriP directly) 5 camper group 10 camper group By June 15th, you will be informed whether or not your child has received a scholarship. *****Any balance is due by the Friday before your camp begins ***** If payment is not received by this date and no alternative plan has been made by contacting our office at (805)893-5899 or scwripywc@gmail.com, you forfeit your 2017 scholarship award and deposit, and your student will no longer be enrolled in Young Writers Camp. SIXTH CANCELLATIONS Any application cancellations made prior to May 30, 2017 will be refunded, minus a $35.00 administrative fee per student. Cancellations made by May 30, 2017 will be refunded $175 per full-paid enrollment. Cancellations made after May 30 cannot be refunded. SEVENTH SCHOLARSHIPS The Young Writers Camp offers partial scholarships that award registration fee discounts to families needing financial assistance. Are you interested in applying for a scholarship? Yes No If you marked no, please skip ahead to the NINTH section. If you marked yes, please fill in the EIGHTH section.
5 EIGHTH SCHOLARSHIP APPLICATION PARENT INFORMATION Annual household income $ Number of family members supported by this income In the space provided below, provide a short statement explaining why you are applying for a scholarship. NINTH SEND IN YOUR COMPLETED APPLICATION & PAYMENT IN ONE ENVELOPE 1) Please double check that you have completed all fields on the form, especially signatures and dates. 2) Make sure you have one completed application for EACH student. 3) Make out ONE check or money order to UC REGENTS for the total amount of ALL students being enrolled. Cash payments must be hand delivered. 4) Write your student(s) name(s) on the memo of the check or money order. 5 ) DOUBLE CHECK THAT YOUR PAYMENT IS MADE OUT TO: UC REGENTS ***We are unable to accept checks made out to any other name *** 6) Mail or hand deliver completed applications and payment to: Young Writers Camp South Coast Writing Project Gevirtz Graduate School of Education University of California, Santa Barbara Santa Barbara, CA 93106-9490 *PLEASE NOTE: Your child s spot in camp WILL NOT be reserved until all materials and final payment have been received.