Name of Camper
*
First Name
Last Name
AGE
*
Guardian Name
*
First Name
Last Name
WEEK OPTIONS
*
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next
( X )
WEEK 2: July 13th-17th
$200.00
$
200.00
Time: 10-12
Quantity
0
1
2
3
4
5
6
7
8
9
10
11
12
Item subtotal:
$0.00
$
0.00
WEEK 3: July 27th-31st
$200.00
$
200.00
Time: 10-12
Quantity
0
1
2
3
4
5
6
7
8
9
10
11
12
Item subtotal:
$0.00
$
0.00
DAILY DROP
$60.00
$
60.00
Can’t make it the entire week of camp/ join us at a daily drop in.
WEEK
Quantity
DAY
Week 1
0
1
2
3
4
5
6
7
8
9
10
11
12
Monday
Tuesday
Wednesday
Thursday
Friday
Week 2
0
1
2
3
4
5
6
7
8
9
10
11
12
Monday
Tuesday
Wednesday
Thursday
Friday
Week 3
0
1
2
3
4
5
6
7
8
9
10
11
12
Monday
Tuesday
Wednesday
Thursday
Friday
Total
$0.00
$
0.00
Credit Card
Email
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example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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