Summer Camp Application

Child's Information

Child's Name Child's Preferred Name/Nickname Date of Birth

Male Female

Parent/Guardian Information

Name Relationship to the Child Email Address Phone Number Address Address Line 2(Optional) City State Please select a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code

Emergency Contact Information

Name Email Address Phone Number Relationship to the Child Address Address Line 2(Optional) City State Please select a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code

By signing this enrollment application, the Parent/Guardian above understands and accepts that the camp fee is non-refundable and non-transferable once we receive payment. Upon receipt of a completed enrollment application, we will email you a payment link to secure the spot.

I Understand and accept the policies.

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