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Summer Camp Registration Form 2024
Please fill out this form for each child (Example: If you have two children, please fill out a separate form for each child)!
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* Indicates required question
Camper Name (First and Last)
*
Your answer
Camper Date of Birth
*
MM
/
DD
/
YYYY
Camper Age
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Billing Address (if different)
Your answer
Additional Email Address(es) you would like on file
Your answer
Important Medical Information and/or Allergies (Or any other information that could affect your child's camp experience)
*
Your answer
Mother's Name
(First and Last)
*
Your answer
Mother's Phone Number
*
Your answer
Father's Name (First and Last)
*
Your answer
Father's Phone Number
*
Your answer
Emergency Contact Name (other than yourself: FIRST AND LAST NAME)
*
Your answer
Emergency Contact Phone Number
*
Your answer
Emergency Contact Relationship to Camper
*
Your answer
Which weeks is your child attending?
*
Week 1: May 28- May 31 (Carnival! Under the Big Top)
Week 2: June 3- June 7 (Medieval Times)
Week 3: June 10- June 14 (Beach Blast!)
Week 4: June 17-June 21 (Day with Dinosaurs)
Week 5: June 24- June 28 (Zoo Break! Lions, Tigers & Bears, OH MY!)
Week 6: July 8- July 12 (Rainforest Adventure)
Week 7: July 15-July 19 (Vroom Vroom!)
Week 8: July 22- July 26 (Olympic Week)
Week 9: July 29- August 2 (Alien Invasion)
Required
Which age group and camp will your child be enrolled in?
*
Full Week Camp (3-4 Year Old's): $250/ week
Single Day Camp (3-4 Year Old's): $55/ single day
Half Day Camp (3-4 Year Old's): $45/half day
Full Week Camp (5-12 Year Old's): $225/week
Single Day Camp (5-12 Year Old's): $50/single day
Half Day Camp (5-12 Year Old's): $40/half day
Before Care: $8/day
After Care: $8/day
Required
Camper's T-Shirt Size:
Note: We will try our best to give your child the size you specify. However, if we run out of that size, we will give them the next most appropriate size.
CXS
CS
CM
CL
CXL
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List all additional persons who are authorized to pick up your child (if applicable; FIRST AND LAST NAMES):
*
Your answer
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