Summer Registration

Email *

Parent/Guardian Name *

First

Last

Zip Code

What classes are you registering for? *

Child's Name *

First

Last

Child's Age *

Child #2 Name

First

Last

Child's #2 Age

Emergency Contact Name & Number *

Pick Up/Drop Off Authorization(s) Name

who is authorized to pick up your child in case of emergency

Pick Up/Drop Off Authorization(s) Relation to Child

Pick Up/Drop Off Authorization(s) Phone Number

Please indicate any medications that will need to be stored during camp *

Lunch will be provided daily, please list any food allergies *

Any illnesses, ADA requirements, medical complications we should know about? *

Comments or Questions

There is a $210 registration fee due before classes can begin. After submission of the registration form, you will be re-directed for payment.