Student Information
Last Name:
Grade:
 (from Sept)
School:
Parent Information
First Name:
Last Name:
Phone:
Email:

Address:
City:
State:
Zip Code:
Daily Camp Schedule
Drop off Time Morning Session Lunch Break Afternoon Session Activity Pickup
8:30 AM - 9:00 AM 9:00 - 12:00 PM 12:00 - 1:00 PM 1:00 - 4:00 PM 4:00 - 5:00 PM 5:00 - 5:30 PM

Choose Courses ** (Please select the location to see the list of courses available for each week.)
Week Location Course Price
Week 1 (6/12-6/16)
Week 2 (6/19 - 6/23)
Week 3 (6/26 - 6/30)
Week 4 (7/05 - 7/07)
Week 5 (7/10 - 7/14)
Week 6 (7/17 - 7/21)
Week 7 (7/24 - 7/28)
Week 8 (7/31 - 8/04)
Week 9 (8/07 - 8/11)
Week 10 (8/14 - 8/18)
Total:

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