2020 Christ's Church PRESCHOOL Summer Camp Program (Please complete one form for each student).
Address: 745 Davenport Farm Rd, Winterville, NC 28590
(252) 353-2967 or preschool@ccg.church
Email address *
Student's First Name *
Your answer
Student's Last Name *
Your answer
Date of Birth (Ages 2-5) *
MM
/
DD
/
YYYY
Student's Gender *
Parent's / Legal Guardian's First Name *
Your answer
Parent's / Legal Guardian's Last Name *
Your answer
Parent's / Legal Guardian's Relationship to Child (Mother, Father, etc.) *
Your answer
Street Address *
Your answer
Street Address Line 2
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone Number
Your answer
Work Phone Number
Your answer
Mobile Phone Number *
Your answer
Dates Requested - $65 per week (minimum enrollment of 2 weeks). Select all that apply. *
Required
I understand I will receive an invoice for my child's registration fee of $25 which must be paid before enrollment is confirmed. *
Required
A copy of your responses will be emailed to the address you provided.
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