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Colonial Kids Camp Registration Form

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Colonial Kids Camp Registration Form Powered By Docstoc
					Colonial Kids Camp Registration Form


Camper’s Name                                           Age (at camp)                                                    Birth Date


School                                       Entering Grade


Address


City                                                    State                                                            Zip Code


Parent/Guardian                              Phone Number                     Cell Phone                                 Work Phone



Parents’ E-mail Address           Please Use All Capitals and Write Legibly   (This will be our main form of communication with you)




Signature of Parent or Guardian                                                                      Date

                                                                                                              Mail Registration Form
                                                                                                              to:
Accepted Campers will be notified by May 17 at which time                                                     Cheryl Heck
                                                                                                              1469 South Mountain
tuition payment in full will be due. Tuition is $140 ($110 for                                                Rd
NYCHAPS members).                                                                                             Dillsburg, PA 17019


Please mail this form along with the medical information form together.

				
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