Spring Break Camp 2017
Registration form for Spring Break Camp 2017 at Voyager Academy. A separate form must be completed for each child. This camp is only for students grade K- 8. Non-voyager academy students may attend!
Payment- Please enter the time stamp shown on your orgsonline or payment receipt.
Please enter the time stamp shown on your receipt for the $35/child (non-refundable) payment. Payment must be made at the time of registration! If you are paying by way of your orgsonline account, please enter the time stamp shown on your receipt after submitting payment. If you are paying by check or cash in person, please STOP, and only complete this form AFTER you have submitted payment. You will receive a "time stamp code" to enter on this form, which will enable you to continue. The remaining $100 payment is due on the first day of camp (April 17).
Your answer
Student Information
First Name
Your answer
Last Name
Your answer
Names of persons authorized to pick up your child.
Please list and separate by commas. If none, type "none"
Your answer
Gender
Birthdate
MM
/
DD
/
YYYY
Current Age
Your answer
Grade
Select the grade that the student will be promoted to.
Student Address
street number, street name, city, state, zip, apt/ste
Your answer
Parent Information
Mother's Name (First, Last)
Your answer
Mother's Address (if different from student)
street number, street name, city, state, zip, apt/ste
Your answer
Mother's Email
Your answer
Mother's Work Phone
Your answer
Mother's Cell Phone
Your answer
Father's Name (First, Last)
Your answer
Father's Address (If different from student)
street number, street name, city, state, zip, apt/ste
Your answer
Father's Email
Your answer
Father's Work Phone
Your answer
Father's Cell Phone
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Student Resides With
Required
Emergency Contact
Name, Relationship to child, Phone Number
Your answer
Emergency Contact
Name, Relationship to child, Phone number;
Your answer
Name of Persons Authorized to Pick up your child:
(separate by commas)
Your answer
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