Summer Camp Enrollment

Camp is 1-4pm, Tuesday through Friday

Ages 2.5 - 9 years old (up to 3 non-potty trained per day)

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	* required fields
*Parent First Name
*Parent Last Name
*Email
*Phone
*Address
*City/State/Zip
*Child First Name
*Child Last Name
*Child Date of Birth
	+ Add additional child
	- Remove additional child
*Child First Name 2
*Child Last Name 2
*Child Date of Birth 2
	+ Add additional child
	- Remove additional child
*Child First Name 3
*Child Last Name 2
*Child Date of Birth 3
	+ Add additional child
	- Remove additional child
*Child First Name 4
*Child Last Name 4
*Child Date of Birth 4
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	- Remove additional child
*Child First Name 5
*Child Last Name 5
*Child Date of Birth 5
*Please List Any Special Needs
*Requested Days
Please Check to Charge Card On File
Check if your child is NOT POTTY TRAINED
*Multiple Day Discount Options:
*Please prove you are not a Robot. What is 40 + 5