| CAMPER NAME(S): |
_____________________________________________________ |
| STUDENT AGE(S): |
________________ |
|
| PARENT NAME: |
_____________________________________________________ |
| ADDRESS: |
_____________________________________________________ |
| |
_____________________________________________________ |
| PHONE: |
_____________________________________________________ |
| E-MAIL: |
_____________________________________________________ |
NUMBER OF WEEKS x NO. CHILDREN x $90.00 = : |
________________ |
(Please be sure to check off your sessions above!) |