SURYOYO SUMMER CAMP AT THE HOVNANIAN SCHOOL
Registration Form 2017
Child’s Full Name *
Your answer
Mother’s Full Name *
Your answer
 Father’s Full Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
E-mail Address *
Your answer
Home Phone *
Your answer
Mother’s Cell Phone *
Your answer
Father’s Cell Phone *
Your answer
Church You Are a Member Of *
Your answer
Date of Birth/Age *
MM
/
DD
/
YYYY
Grade Entering in September *
Your answer
My child will be picked up by: relation/cell phone number *
My child will be picked up by: relation/cell phone number (Please list all authorized individuals who can pick up your child/children along with their cell phone numbers)
Your answer
T-shirt size *
Would you like to order more t-shirts at an additional charge of $5 each?
You are provided with two t-shirts per camper
How many T-shirts would you like?
Your answer
Would you like the busing service?
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