What grade will the camper be starting in the 2023-2024 school year? *
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Camper's birthday *
MM
/
DD
/
YYYY
Parent/guardian names *
Your answer
Home address *
Your answer
Parent/guardian's email address *
Your answer
Parent/guardian's phone numbers (list all phone numbers for parent contact please) *
Your answer
Emergency contact (Please list name and phone number for any emergency contacts) *
Your answer
People allowed to pick up your child from camp other than parents/guardians listed above (if none, please enter none): *
Your answer
Allergies or medical concerns (Please enter "none" if there are no concerns): *
Your answer
**Shirt Size - Campers will only receive a shirt if registration is paid to the front office before noon on June 16th. *
The camp fee of $175 may be paid by cash or check in the front office. If you wish to be billed through your FACTS account, please indicate that below. *
To receive a t-shirt, camp registration and fee must be paid in full to the school office by noon on Friday, June 16th. *
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