Next Generation Farm Camp Enrollment
Please complete the form below for Next Generation summer camp. Camp dates:__July 25th- July 29th _
Camper Last Name
Camper First Name
Camper Age (during camp)
Parent Address, City
Parent Phone (xxx) xxx-xxxx
Parent 2 or Emergency Contact Name
Parent 2 or Emergency Contact Phone (xxx) xxx-xxxx
Camp runs M-F from 9:30am-3pm at COM Indian Valley College. Will your camper need extended care (3-4:30pm) for an additional fee?
Please note any camper special needs or "none".
To complete your enrollment, please submit payment to Next Generation for $290. Add $100 for extended care.
and click on the "DONATE" button. Be sure to write your CAMPER NAME in the "Purpose" field. Or, send a check to Next Generation, 636 Lindaro St., Suite 100, San Rafael, CA 94901. Your space is not confirmed until payment is received.
Payed via PayPal
I'll pay later.
Please submit your form when you are done.
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