Summer Camp Registration
Student Name
*
First
Last Name
Child's School
Age
Grade Level
K
1
2
3
4
5
Allergies/Health Concerns
Student # 2
First Name
Last Name
Age
Grade Level
K
1
2
3
4
5
Allergies/Health Concerns
Parent's Name
*
First Name
Last Name
Home phone
*
-
Area Code
Phone Number
Work Phone
*
-
Area Code
Phone Number
Cell Phone
*
-
Area Code
Phone Number
Emergeny Contact/Phone Number (Must list someone other than name provided above)
*
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
My Products
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WEEK 1: Nature Camp: JUNE 10-14
$
165.99
Number of Children
1
2
3
4
5
6
7
8
9
10
WEEK 2: Splish Splash Science JUNE 17-21
$
165.99
Number of Children
1
2
3
4
5
6
7
8
9
10
WEEK 3: Spy Academy JUNE 24-28
$
165.99
Number of Children
1
2
3
4
5
6
7
8
9
10
WEEK 4: Nature Camp JULY 8-12
$
165.99
Number of Children
1
2
3
4
5
6
7
8
9
10
WEEK 5: Splish Splash Science JULY 15-19
$
165.99
Number of Children
1
2
3
4
5
6
7
8
9
10
WEEK 6: Spy Academy JULY 22-26
$
165.99
Number of Children
1
2
3
4
5
6
7
8
9
10
WEEK 7: Nature Camp JULY 29-AUG 2
$
165.99
Number of Children
1
2
3
4
5
6
7
8
9
10
WEEK 8: Splish Splash Science AUG 5-9
$
165.99
Number of Children
1
2
3
4
5
6
7
8
9
10
Total
$
0.00
Field trips will be included during summer camp at an additional cost. Parents will be notified at the beginning of the week of when/where these field trips will take place. Field trips can be subject to change based on weather conditions. ALL FIELD TRIPS are optional to parents.
*
I acknowlege that there will be Field Trips included as part of each camp at an additional cost.
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