Peachtown Camp Registration Form
For our records, please complete one form for each child attending camp. If you have any questions, please email Alyssa.peachtownschool@gmail.com
Primary Home Address
Your answer
Date of Birth (MM/DD/YYYY)
Your answer
Parent/Guardian Name(s)
Your answer
Camper's Name
Your answer
Gender
Required
Parent/Guardian Address
Your answer
Home (Primary) Phone
Your answer
Work Phone
Your answer
Age (by June 12)
Cell Phone
Your answer
Email Address
Your answer
Special Needs or Requests
Your answer
Week 1 June 12-16
Week 2 June 19-23
Amount Due
We require a deposit of $25 per week by June 5. This deposit secures your child's spot and is non-refundable. The remaining balance is due by the start of camp. Payment options include Paypal (accepts all major credit cards) and personal check.
Your answer
Amount Paid
Enter the amount you are paying upfront - minimum $25 deposit per week
Your answer
Due at Check-in
Enter the amount you still owe at check-in
Your answer
Payment Method
Permission - activities
Required
Permission - photographed (please note that we NEVER share names or identifying information along with photos we use online).
Required
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