JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2023 Summer Municipal Camp Registration Form
Must fill out a form for each camp for each child. Do not use one form for multiple camps. Contact us at
717-738-1167 x106 or
maria@ephratarec.com
with questions.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Camp Name (Exactly As It Appears in Flyer)
*
Your answer
Level (Swimming Lessons Only)
Level 1
Level 2
Level 3
Level 4
Level 5
Clear selection
Camp Dates
Your answer
Camp Time
Time
:
AM
PM
Participant Name
Your answer
Participant Date of Birth
MM
/
DD
/
YYYY
Current Grade
Your answer
Parents' Names (Father and Mother)
Your answer
Parent Cell
Your answer
Parent Email Address
*
Your answer
Street Address
Your answer
Municipality **Participants who do not reside in a participating municipality must pay the class price listed with each program.
Your answer
Next
Page 1 of 3
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
