CAMP REGISTRATIONCAMP REGISTRATIONCAMP REGISTRATION Register for Summer Camp 2021Please enable JavaScript in your browser to complete this form.How many campers are you registering? *1234Camper InfoCamper #1 Name *FirstLastCamper #1 Birthday *Camper's birthdayCamper #1 Age *Camper's age on Jun 1, 2021Camper #2 Name *FirstLastCamper #2 Birthday *Camper's birthdayCamper #2 Age *Camper's age on Jun 1, 2021Camper #3 Name *FirstLastCamper #3 Birthday *Camper's birthdayCamper #3 Age *Camper's age on Jun 1, 2021Camper #4 Name *FirstLastCamper #4 Birthday *Camper's birthdayCamper #4 Age *Camper's age on Jun 1, 2021Home Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMember? *YesNoMember Number *Emergency Contact InformationParent #1 Name *FirstLastParent #1 Mobile Phone *Parent #1 Email *EmailConfirm EmailParent #2 Name *FirstLastParent #2 Mobile Phone *Parent #2 Email *EmailConfirm EmailBackup Contact name (if parents unreachable) *FirstLastRelationship to camper *GrandparentOther family memberOtherRelationship (if other) *Backup contact Email *EmailConfirm EmailBackup Contact Mobile Phone *List all Medical Conditions *If no known medical conditions, please enter N/AList all known allergies *If no known allergies, please enter N/ACamp enrolmentSelect weeks of enrolment below *Week 1 : Jun 1 - Jun 4Week 2 : Jun 7 - Jun 11Week 3 : Jun 14 - Jun 18Week 4 : Jun 12 - Jun 25Week 5 : Jun 28 - Jul 2Week 6 : Jul 5 - Jul 9Week 7 : Jul 12 - Jul 16Week 8 : Jul 19 - Jul 23Week 9 : Jul 26 - Jul 30Week 10 : Aug 2 - Aug 6It is also possible to sign up for only specific days within each of these weeks, please chat with our staff about these options when making paymentsMember Pricing *10 weeks - $ 2,250.005 weeks - $ 1,175.001 week - $ 265.001 day - $ 65.00Pricing *10 weeks - $ 2,495.005 weeks - $ 1,275.001 week - $ 295.001 day - $ 75.00Submit
