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Incoming 3rd Grader Summer Registration
This registration form is used to register for summer camp.
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* Indicates required question
Email
*
Your email
Parent First Name
*
Your answer
Parent Last Name
*
Your answer
Address
*
Your answer
Cell Phone Number
*
Your answer
Child First Name
*
Your answer
Child Last Name
*
Your answer
School Name
*
Your answer
After you submit your response, you will receive an email confirming your registration. Please submit your payment via the following options below. Please include the child's name in the notes.
*
Cash App $DrCRHarris
Paypal charris82
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A copy of your responses will be emailed to the address you provided.
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