CCA November 5th Program Registration
Join us 10am at Auer Farm 158 Auer Farm Rd, Bloomfield, CT 06002 Join us for Parent Communication and Retention
Name
First Name
Last Name
Email
example@example.com
Camp Name
How many additional staff will be joining you?
1
2
3
4
5
6
7
8
Person 1
First Name
Last Name
Email
example@example.com
This person will be joining:
In Person
Via Zoom
Person 2
First Name
Last Name
Email
example@example.com
This person will be joining:
In Person
Via Zoom
Person 3
First Name
Last Name
Email
example@example.com
This person will be joining:
In Person
Via Zoom
Person 4
First Name
Last Name
Email
example@example.com
This person will be joining:
In Person
Via Zoom
Person 5
First Name
Last Name
Email
example@example.com
This person will be joining:
In Person
Via Zoom
Person 6
First Name
Last Name
Email
example@example.com
This person will be joining:
In Person
Via Zoom
Person 7
First Name
Last Name
Email
example@example.com
This person will be joining:
In Person
Via Zoom
Person 8
First Name
Last Name
Email
example@example.com
This person will be joining:
In Person
Via Zoom
If you need to pay by check please list the name and address of where to send the invoice.
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PAY BY CC - CCA MEMBERS
If you or your camp is a CCA member please use this option to Pay by CC
$
10.00
Quantity
1
2
3
4
5
6
7
8
NON CCA MEMBER PAY BY CC
If you or your camp are NOT CCA members please use this option to Pay by CC
$
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
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