Summer Camp Registration

Summer Camp Registration

Register for our Summer Camp by providing camper and contact information below. Camp will run from June 1st through August 18th.
A registration fee of $100/child or $150/family will be required to hold your child's spot.
Camper's Full Name*

First NameLast Name
Camper's Date of Birth*

MonthDayYear
Date
Second Camper Full Name

First NameLast Name
Second Camper Date of Birth

MonthDayYear
Date
Third Camper Full Name

First NameLast Name
Third Camper Date of Birth

MonthDayYear
Date
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Email Address
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name (other than parent)*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Please list any allergies, medical conditions, or special needs
Additional Notes or Comments

Payment Section