Clone of 25' Fall Break Camp

26' Fall Break Camp Registration

Oct. 5-9 2026
CHILD INFORMATION:
Child Name

First NameLast Name
Child Name

First NameLast Name
Birth Date

MonthDayYear
Grade
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Fall Break Options: Invoice sent separtely via email Cost: $180 week AfterSchool Campers $150 week. Day Only Oct 12-13 $30
MEDICAL INFORMATION
Medical/Allergies Concerns
Signature
Should be Empty:

26' Fall Break Camp Registration