The Scranton Cultural Center at the Masonic Temple's 2017 Summer Camp Registration Form
DEPOSITS: A NON-REFUNDABLE DEPOSIT of $25 PER SESSION must be submitted to reserve your spot on the camp roster. You will be invoiced for the remaining balance. Your deposit will be applied to your tuition balance.

REGISTRATION FEE: There is a one-time, non-refundable REGISTRATION FEE of $25 for all first-time campers.

MULTI-SESSION/SIBLING DISCOUNT: Sign up for more than one session (includes sibling registrations) and receive a 5% discount on your full tuition.

Email address
Name of Camper
Your answer
Sex
Age as of 6/1/17
Your answer
Grade as of 9/1/17
Your answer
T-Shirt Size
Sibling of:
Your answer
School
Your answer
District of Residency:
Your answer
Street Address
Your answer
City
Your answer
State
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Zip
Your answer
(1) Name of Parent or Guardian
Your answer
Relationship:
Your answer
(2) Name of Parent or Guardian
Your answer
Relationship:
Your answer
Primary Phone
Your answer
Secondary Phone
Your answer
Secondary E-Mail Address
Your answer
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