Summer Camp 2008 Registration Form
Registration begins on April 1st, 2008!

Please make sure to fill out all the items
(if no information is available, please write N/A)

 
Part I. Camper's Information

Camper's Name:
日本語名：
Nickname:
Gender: Boy Girl
Birthday (mm/dd/yyyy):
Age (as of first day of camp) :
Current Japanese School: (select all that apply) 
Washington Japanese Language School (日本語学校)
Japanese Immersion School
Washington Japanese Heritage Center (継承センター)
Sakura Yochien
Tanpopo Yochien
Himawari Yochien
Other
N/A
Years in the US:
Home Languages: Japanese % English%
Other % (Please provide what language your child speaks at
home if other than Japanese or English)
Any Allergies:
Additional Information(health issues, medications, anything else that needs to be concerned):

What do you expect from this camp? What do you want your child to learn and experience?:


Part II. Guardians' Information

Primary Guardian's Name:
Relationship with the Camper:
Secondary Guardian's Name:
Relationship with the Camper:
Main Address:
City: State: Zip Code:
Can we list your Zip Code for the Carpool purpose? Yes No
(*The list will be distributed to only registered participants)

Phone Number: Home Cell
Other
E-mail Address:
This e-mail is for English Text Only
can read Japanese text
Other Emergency Contact:
Name Relationship
Phone Number


Part III. Sessions
Please select the plan/program you would like to sign up

Session 1(MD): Package (5 Weekdays + Thursday Sleepover)
Partial Plan (please mark all the dates you participate)
July 7 (Mon) July 8 (Tue) July 9 (Wed)
July 10 (Thu) July 10 Sleepover July 11 (Fri)
Extended Program
July 7 (Mon) July 8 (Tue) July 9 (Wed)
July 10 (Thu) ← Only if your child is NOT staying for Sleepover
Session 2(VA): Package (5 Weekdays + Thursday Sleepover)
Partial Plan (please mark all the dates you participate)
Aug. 18 (Mon) Aug. 19 (Tue) Aug. 20 (Wed)
Aug. 21 (Thu) Aug. 21 Sleepover Aug. 22 (Fri)
Extended Program
Aug. 18 (Mon) Aug. 19 (Tue) Aug. 20 (Wed)
Aug. 21(Thu) ← Only if your child is NOT staying for Sleepover


Part IV. Homestay/Host Family Option

  • If you are from outside of Washington DC area, do you need us to arrange homestay? Yes No
  • Would you like to sign up a a host family? Yes No Not Sure


    Part V. Additional Information

  • Is this your first time participating O-en Network event?
    Yes No
  • How did you hear about this camp?

Part VI. Payment Option

Please select your payment option

I would like to mail my personal check/money order
(Your invoice will be mailed to you first)
I would like to pay with my credit card
(You will receive the e-mail to tell you the total cost and the information on how to make
a payment with your credit card)