Name *
Contact Number *
Address
E-Mail *
Parent/Guardian Name *
Emergency Contact Name *
Emergency Contact Relation to Child *
Emergency Contact Phone *
PLEASE CHECK DESIRED CAMP OPTIONS
Week 1 First 1/2Second 1/2Full Week
Week 2 First 1/2Second 1/2Full Week
Week 3 First 1/2Second 1/2Full Week
Week 4 First 1/2Second 1/2Full Week
Week 5 First 1/2Second 1/2Full Week
Week 6 First 1/2Second 1/2Full Week
Week 7 First 1/2Second 1/2Full Week
Week 8 First 1/2Second 1/2Full Week
Week 9 First 1/2Second 1/2Full Week
Week 10 First 1/2Second 1/2Full Week
Week 11 First 1/2Second 1/2Full Week
Early Drop Off:
Wk1Wk2Wk3Wk4Wk5Wk6Wk7Wk8Wk9Wk10Wk11
