2024 Hamden Recreation LEGO Summer Camps Registration Form

Build With Ricky

Hamden Recreation 2025 LEGO® Summer Camps

Parents Name:*

First NameMiddle NameLast Name

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email

example@example.com

Student information

Student Name*

First NameMiddle NameLast Name

Date of Birth*

Date

Grade

School

Please list if any health issue: Allergies; special assistant; medications or other information:

Camp Information

July28 - Aug 1, 2025*

Brick Motion: Dance & Move Camp! (8:30 am – 11:30 am)LEGO® Remote Control Fun (12:00 pm – 3:00 pm)All day camps

Payment *

Half day camp: $199.00All day camp: $299.00

Payment methods:*

E-payment: Venmo: Please use "Between friends" for type of transaction or add $15.00 for transaction fee. (860) 861-9391 User name: "Ricky_Wang" (make a note with "Hamden Recreation" + kid information and camp name).Check: Please make check payable to: Build With Ricky LLC. Mailing address: P. O Box 460 Mansfield Center CT 06250. (make a note with "Hamden Recreation" + kid information and camp name)

Note: Your registration seat is only to be booked after paid your payment.

Signature*