Please choose your preferred dates for Summer Camp. Dates are not confirmed until payment is accepted. Minimum of 2 weeks required, weeks do not have to be consecutive.
Preferred weeks: *
Required
1st parent name *
Your answer
1st parent email *
Your answer
1st parent phone *
Your answer
2nd parent name
Your answer
2nd parent email
Your answer
2nd parent phone
Your answer
Home address *
Your answer
Please share the names, relationship and contact information of those who are allowed to pick up your child from Little Leaf at Andrus-on-Hudson