26' Winter Break Camp

26' Winter Break Camp Registration

Dec. 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
Winter Break Options: Invoice sent separately via email Cost: $180wk ($60 a day) AfterSchool Campers $150wk ($30 a day)
MEDICAL INFORMATION
Medical/Allergies Concerns
Signature
Should be Empty:

26' Winter Break Camp Registration