Summer Camp Registration

*Student’s name:  **Please enter the student’s name*Student’s age:     **Please enter the student’s age
*Parent’s name: **Please enter the parent’s name
*Street address:
*City: *Zip:
**Please enter your full address
Home phone: Cell phone: **Please enter at least one phone number.
*Email:

Week 1 (6/5 – 6/9) 8:30am – 12:30pm
1:30pm – 5:30pm
8:30am – 5:30pm
None


Week 2 (6/12 – 6/16)
8:30am – 12:30pm
1:30pm – 5:30pm
8:30am – 5:30pm
None

Week 3 (6/19 – 6/23) 8:30am – 12:30pm
1:30pm – 5:30pm
8:30am – 5:30pm
None

Week 4 (6/26 – 6/30 8:30am – 12:30pm
1:30pm – 5:30pm
8:30am – 5:30pm
None
Closed Week of 4th July


Week 5 (7/10 – 7/14) 8:30am – 12:30pm
1:30pm – 5:30pm
8:30am – 5:30pm
None

Week 6 (7/17 – 7/21) 8:30am – 12:30pm
1:30pm – 5:30pm
8:30am – 5:30pm
None

Week 7 (7/24 – 7/28) 8:30am – 12:30pm
1:30pm – 5:30pm
8:30am – 5:30pm
None

Week 8 (7/31 – 8/4) 8:30am – 12:30pm
1:30pm – 5:30pm
8:30am – 5:30pm
None

Total fees:
(includes $10 registration fee)

**Please select at least one session
**Some required information is missing. Please enter the missing information (above) and resubmit your registration.

Note: Payment is due by the first class. You can bring a check with you to class, or please call Nancy at (352) 383-0880 if you want to pay by credit card over the phone. Thanks and we’ll see you this summer!