Animal Adventure Camp Registration
When: June 17 - 21, 2019
Time: 9:00 AM - 1:00 PM (each day of camp)
Location: Rockbridge SPCA - 10 Animal Place, Lexington, VA 24450
Mailing address: PO Box 528, Lexington, VA 24450
Contact us at: 540-463-5123 or

Tuition: $160.00
- For a family discount, subtract $20.00 per additional child. Start a new form for an additional registration.

Tuition includes:
- Week of camp
- T-Shirt
- SPCA water bottle
- End of week pizza party

* All Campers will need to bring a snack to camp Monday - Thursday.

A $50.00 deposit per camper is due at the time of registration.
Deposits are non-refundable after June 3, 2019.

Full payment is due June 15, 2019.

Deadline to register is June 3, 2019. Space is limited.

Camper's Name: *
Your answer
Age: *
Your answer
Date of Birth: *
Your answer
Gender: *
Your answer
T-shirt Size: *
Please list any allergies:
Your answer
Parent/Guardian Name(s): *
Your answer
Address: *
Your answer
Parent/Guardian Phone Number(s): *
Your answer
Parent/Guardian Email(s): *
Your answer
Emergency Contact: *
Your answer
Emergency Contact Phone Number: *
Your answer
As your child will be taking part in a SPCA activity or event, we would like to ask you for your consent to take photographs of the activity that may contain images of your child. The images would be used for publicity in future events, leaflets, websites, newsletters, and brochures. Please check one of the following: *
Please type your name and today's date. This is considered as your signature for this form. *
Your answer
Method of Payment: *
Amount Paid: *
Your answer
Is your payment including a sibling discount?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service