Summer Camp Enrollment Form

West Linn Bounce Summer Camp Registration
July 8 - 12July 29 - Aug 2
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade*
Name of School*
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Name of School*
Grade*
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
MEDICAL INFORMATION
Physician Name

First NameLast Name
Phone Number

Area CodePhone Number
Parent/ Guardian ListedOther (please let camp staff knowOther
Medical Concerns
Any Allergies?
Please Describe
Please submit camp fee for $380 per child / per week via Venmo:

@Suzanne-Oliver-1
Should be Empty:

West Linn Bounce Summer Camp Registration