Registration FormPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full Name *Phone Number *Age *Email Addres *Parent/Guardian Name Emergency Contact (if different from above)NameAllergies or Dietary RestrictionsPhone NumberCamp Session Selection (if Contact different First Choice *Week 1: June 9 – June 13Week 2: June 16 – June 20Week 3: June 23 – June 27Week 4: July 7 – July 11Week 5: July 14 – July 18Week 6: July 21 – July 25Week 7: July 28 – August 1Second Choice (if first is full)Week 1: June 9 – June 13Week 2: June 16 – June 20Week 3: June 23 – June 27Week 4: July 7 – July 11Week 5: July 14 – July 18Week 6: July 21 – July 25Week 7: July 28 – August 1Special Needs or Additional NotesPayment InformationFull payment of $605 per selected weekPayment Method: Zelle or SquareZelle to: 305-890-0185Submit
