Camp Registration Camp Registration 1 Program Selection2 Student Info3 Parent/Guardian Info Program SelectionPrograms that have met their capacity will not show up on the list. Camp Info Price: $160.00 Middle or High School Group*Current or Rising Middle SchoolerCurrent, Graduated or Rising High SchoolerSelect Camp Location*Emory University - DecaturWoodward Academy - College ParkFulton Science Academy - AlpharettaWealthy Habits - DunwoodyDevry University - Cobb Galleria PkwyHiram High School - HiramDevry University @ Cobb Galleria (MS)June 26-30, 2017Devry University @ Cobb Galleria (HS)There are no options available for this field.Hiram High School (MS)June 26-30, 2017Hiram High School (HS)June 26-30, 2017Wealthy Habits (MS)There are no options available for this field.Wealthy Habits (HS)There are no options available for this field.Woodward Academy (MS)July 10-14, 2017Woodward Academy (HS)Jun 12-16, 2017July 10-14, 2017Fulton Science Academy (MS)Jun 5-9, 2017Jun 12-16, 2017Fulton Science Academy (HS)Jun 5-9, 2017Jun 12-16, 2017Emory University (MS)Jun 5-9, 2017Jul 10-14, 2017Jul 17-21, 2017Jul 24-28, 2017Emory University (HS)Jun 5-9, 2017Jul 10-14, 2017Jul 17-21, 2017Jul 24-28, 2017Camp ID* Student InformationStudent's Name First Last Date of Birth Gender Male Female Current/Rising GradePlease SelectGr 6Gr 7Gr 8Gr 9Gr 10Gr 11Gr 12School AttendingParent/Guardian InformationName First Last How did you hear about Wealthy Habits?Please Select11Alive WebsiteAha! ConnectionAlpharetta MomsAtlanta Moms BlogAtlanta Moms WebsiteAtlanta ParentAtlanta Parent ExpoAtlantaSummerCamps.orgBrookhaven BuzzCamp MillionaireCineMomsCross Keys Career EventDecatur DispatchDrew Charter ExpoDunwoody Career EventDunwoody DispatchEmory Camp ExpoFacebookFederal Reserve BankFriend or Family MemberHomeschool NetworkI Don't RememberInternet SearchJunior AchievementLilburn LivingMidtown MessengerNorcross NewsOtherPounce PressSchool Career FairSchool NewsletterStudent Education Programs WebsiteStudent is a Returning StudentSummer Camp WebsiteTeen Forum @ LovetteTeenLife.comTucker TimesWealthy Habits NewsletterAddress/Credit Card Billing Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Enter Email Confirm Email Are there any special circumstances you would like us to be aware of?Cancellation Policy*Transfers – In order to transfer payment to another program date, we must be provided a minimum of a seven-day notice. We will only transfer payment one time. Refunds – Notification at least two weeks prior to program date will be eligible for a refund minus a $10 service fee. Late cancellations are not eligible for a refund. No Shows – No prior notification will result in forfeit of payment and may not be transferred. I have read and understand the cancellation policy. Liability Waiver* Liability Release and Parental Consent Form - In consideration for the above program, I hereby waive, release, and discharge any and all claims for damages for personal injury, property damages or which may hereafter occur to me or my child as a result of participation in said event. This release is intended to discharge in advance the Jonathan D. Rosen Family Foundation, its officials, officers, trustees, employees, volunteers and agents from liability, even though that liability may arise out of perceived negligence on the part of persons mentioned above. It is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assignees. I have read and understand the above liability release and agree to all of its terms and conditions. Photo Release*I hereby authorize the Jonathan D. Rosen Family Foundation to publish the photographs taken of me and/or the registered minor child, and our names, for use in the Wealthy Habits website and for display in other marketing materials. I release the JDRFF from any expectation of confidentiality for the undersigned minor children and myself and attest that I am the parent or legal guardian of the child register and that I have the authority to authorize the JDRFF to use their photographs and names. I acknowledge that since participation in publications and websites produced is voluntary, neither the minor children nor I will receive financial compensation. I further agree that participation in any publication and website produced by the JDRFF confers no rights of ownership whatsoever. I release its contractors and its employees from liability for any claims by me or any third party in connection with my participation or the participation of the registered minor child. I agree I do not agree Additional PurchasesWould you like to add a Camp T-shirt?$10NoYesSelect a t-shirt sizeYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-LargeDo you need EXTENDED CARE?$75 for the weekNoYesExtended Care Added Price: $75.00 Would you like to add the Woodward bus service?$25 for the weekNoYesBus Service Added Price: $25.00 Select Bus LocationSelect a Location1. Woodward North Campus – 6565 Boles Rd., Johns Creek/Duluth, 30097 (in front of school) 7:15am & 5:35pm2. Lowe’s Home Improvement – 4950 Peachtree Industrial Blvd., Chamblee, 30319(front parking lot) 8:05am & 4:50pm3. Abernathy Square – 6615 Roswell Rd., Atlanta/Sandy Springs, 30328 (by Hardee’s) 7:30am & 5:15pm4. Trinity Presbyterian Church – 3003 Howell Mill Rd. N.W., Atlanta/Buckhead, 30327 (Moores Mill side of church) 8:00am & 4:45pm5. North DeKalb Mall – 2050 Lawrenceville Hwy., Decatur, 30033 7:25am & 5:25pm6. Northlake Mall – 4800 Briarcliff Rd., Atlanta, 30345 (in front of Macy’s) 7:45 & 5:05pm7. Ansley Mall – 1700 Monroe Dr., Atlanta, 30309 (in front of Kroger) 8:15am & 4:40pmDo you need a STUDENT PARKING PASS?$25.00 Week Pass Emory parking is $12/day without pass purchase.NoYesParking Pass Added Price: $25.00 Discount Code Purchase Total $0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name EmailThis field is for validation purposes and should be left unchanged.