Summer Registration Form

Summer Registration Form

To book for a place in the the camp, you must complete the form below accurately.
Child's Name

First NameLast Name
Birth Date

MonthDayYear
Home Phone Number
Mobile Number
Email Address
example@example.com
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide any medical or dietary restrictions you have
How did you hear about Camp?

Family Information
Parent/Guardian's Name

First NameLast Name
Contact Phone Number
E-mail Address
example@example.com

Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Relationship to Student

Camp Week Registration $360/week

June 9-13June 16-20June 23-27

Should be Empty: