2021 MBF Farm Camp Registry

2021 MBF Farm Camp Registry
Name of Student *

First Name Last Name
Age of Student *
Name of Parent *

First Name Last Name
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Email *
example@example.com
Weekly Rates- To be paid in advance, no refunds (donated to scholarship farm program) *
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Week 1: June 28-July 2 Ages 5-10
$ 75.00

Week 2: July 5-July 9 Ages 5-10
$ 75.00

Week 3: July 26-July 30 Ages 5-10
$ 75.00

Tots Program June 28-July 2 Ages 3-4 only
$ 75.00

Donation for Scholorship Program Thank you for believing in our mission!
$ 1.00 Quantity

Total

$ 0.00
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