The Scranton Cultural Center at the Masonic Temple's 2018 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 *
First Name of Camper *
Your answer
Last Name of Camper *
Your answer
Sex
AGE as of July 2018 *
Your answer
GRADE as of September 2018 *
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 *
Your answer
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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This form was created inside of Scranton Cultural Center at the Masonic Temple.