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Summer Camp Programs
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Childs First and Last Name  *
Child's Date of Birth *
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DD
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YYYY
Child's Age *
Home phone *
Family E-Mail *
Mailing address *
Street address if different from above *
Parent/Guardian 1 name and contact *
Emergency contact name and number (OTHER than parent or guardian) *
Please list the name of anyone authorized to pick your child up *
Medical issues, daily medication or special needs *
Allergies *
Which camp are you registering for? *
I understand that a deposit of $150.00 is required by June 1st, 2025 to hold my child's spot.  The amount will go toward the cost of the week.  REFUNDS WILL NOT BE AUTHORZIED. *
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