Child's Name *

First Name

Last Name

Parent Contact

First Name

Last Name

Parent’s Phone *

(###)

###

####

Parent's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Week One (June 29-July 3)

Morning

Afternoon

All Day

Week Two (July 6 - July 10)

Morning

Afternoon

All Day

Week Three: July 13 - July 16

Morning

Afternoon

All Day

None

Morning Camp

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

Week 9

Week 10