No-School Days
Minimum of 4 kids needed for the program to take place
Student Name
First Name
Middle Name
Last Name
Age
Parent Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Emergency Contact Name
*
Emergency Contact Phone Number
*
E-mail
*
Authorization for First Aid Treatment: in the event that parents/guardians named on this form cannot be reached, I authorize officials of the Blue Giraffe Education Center to consent on my behalf, to provide emergency treatment for my child
*
I agree
Please list allergies if any and anything we should know about your child/children
Dates:
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Camp Day
$
95.00
Quantity
Second Child (Sibling) 10% Off
$
79.20
Quantity
Total
$
0.00
Payment Methods
Credit Card
Google Pay
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