Summer Camp Registration Form:

Use this form to Register for Summer Camp! Or print and mail it with payment.
Student Name		Age
Parent Name
Address
City		State	Zip
Day Phone		Evening Phone
Cell Phone		Email
Will you need Late Pickup	Yes No	Dates of Late Pickup
Allergies

Summer Camp Dates		AM PM Full
	June 23-27
	July 7-11
	July 21-25
	August 4-8