-- STUDENT REGISTRATION --
Camp Sessions
9:00am - 2:00pm
Select 1 or more weeks
July18 - 22, 2011
July 25 - 29, 2011
1 week
$150
current students
1 week
$185
new students
10% sibling discount
July 18 - 22, 2011
July 25 - 22, 2011
Parent First Name:
Parent Last Name:
Student First Name:
Student Last Name:
Student Age:
Address:
City:
State:
Zip:
Primary Phone Number:
(Phone Number)
Secondary Phone Number:
Email:
(E-mail)
Emergency Contact Name:
Emergency Contact Number:
Health Insurance Provider:
Health Insurance Policy #:
Health Insurance Primary Name:
NOTE:
You can select and register for
more than one class
