Summer Registration Form

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Complete form for each Student you are enrolling into Summer Programming.

MEN Incorporated Saturday Day Camp will kick off on July 1st to August 5th. Each session will be from 10am to 2pm, lunch included.

Enrollment is $15.00 per student which includes supplies, lunch each week, T-Shirt and Field Trip!

Email *

Student Name *

Student Age *

Students Must be 8 - 15

Student Grade *

Grade as of 2023-2024; Grades 4 - 8 Only

Student T-Shirt Size *

XXL

Any Allergies MEN Inc should be aware of? *

"NKA" if there are No Known Allergies

Parent (Guardian) Name *

Address *

Preferred Contact Number *

Preferred E-Mail Address *

Emergency Contact *

Additional Contact other than Primary Parent or Guardian

Emergency Contact Phone Number *

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