Holiday Camps

Select your Camp(s)*

Fall Break CampThanksgiving CampWinter Break CampSpring Break CampSummer Camp
Student Name*

First NameLast Name
Student's Date of Birth*

MonthDayYear
Date of Birth
Grade*
School*
School District*
Allergies*
Mother Name*

First NameLast Name
Mother Email*
example@example.com
Mother Phone Number*
Please enter a valid phone number.
Father Name*

First NameLast Name
Father Email*
example@example.com
Father Phone Number*
Please enter a valid phone number.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Authorized Pickup*

Mother (as mentioned above)Father (as mentioned above)Other
Relation to the child*
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Mandatory Pickup/ Drop-Off Policies and Procedures*
PAYMENT

Select your option(s):*

Fall Break Camp (FBC)

Fall Break Camp per Week5 Day Camp October 11 - October 17

$245.00 Time

(FBC) Add Early/After Care per week

$70.00

(FBC) Per Day Option 9:00 AM - 3:00 PM

$60.00 Number of Days

Thanksgiving Camp (TGC)

Thanksgiving Camp per week4 Day Camp November 24 - November 28

$220.00 Time

(TGC) Per Day Option 9:00 AM - 3:00 PM

$60.00 Number of Days

(TGC) Add Early/After Care per week

$70.00

Enter coupon

Total

$0.00

Select your per day(s)*

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Enrollment Agreement
Please Read carefully & SIgn*
By signing below, I agree to the above Enrollment Agreement.*

Clear
Date of Consent*

MonthDayYear
Date
How did you hear about us*
I would be interested in*

AllSpring Break CampSummer Break CampFall Break CampThanksgiving Break CampWinter Break Camp
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PAYMENT