2025 Spring Break Camp Detailed Registration Form

Spring Break Camp Registration 2025

Camp choices are for Kids and Teen camps during Spring Break April 14-17
Camper Information
Camper's Name 1*

First NameLast Name
Camper's Name 2

First NameLast Name
Camper's Name 3

First NameLast Name
Are you registering for Kids or Teen Camp*
Ages*
Gender*
YesNo
Parent/Guardian Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Number
Format: (000) 000-0000.
Cell Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Format: (000) 000-0000.
Alt. Phone Number*
Format: (000) 000-0000.
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the camper prescribed any medications? If yes, please explain any instructions.*
YesNo

Camp Weeks - Sibling Discount ($20) reflected in multiple children registration*

Crafty Creators (Ages 6-12) - April 14- 17 - (M - Th 8:30am - 12:30pm)

Come Spring into action and create with us. We will use our imagination to create a variety of different arts and crafts projects. Snacks included, campers are welcome to bring their own snacks.

$165.00 Quantity

Teen Expressive Art Retreat: (Ages: 13 - 17) - April 14 - 17 (M - Th 2:30pm - 5:30pm)

Come put your creative brain to work and learn how to express yourself through art. Learn various techniques and styles of art. Snacks included, campers are welcome to bring their own snacks.

$150.00 Quantity

Total

$0.00

Credit Card

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date*

MonthDayYear
Date
Signature*
Should be Empty:

Spring Break Camp Registration 2025

Camper Information

Credit Card