Camp Form 2025

Address

Address

Emergency Contact Name
Emergency Contact phone number
Pediatrician Name
Pediatrician phone number
Child's T-Shirt Size

SmallMediumLargeExtra-large
Week One

$375 Summer Camp (June 30 - July 3rd / no camp July 4th)$60 Food Program$40 Early Care$40 Late Care
Week Two

$375 Summer Camp (July 7 - July 11)$60 Food Program$50 Early Care$50 Late Care
Week Three

$375 Summer Camp (July 14 - July 18)$60 Food Program$50 Early Care$50 Late Care
Week Four

$375 Summer Camp (July 21 - 25)$60 Food Program$50 Early Care$50 Late Care
Week Five

$375 Summer Camp (July 28 - Aug 1)$60 Food Program$50 Early Care$50 Late Care
Did you receive a scholarship

YesNo
Please name the scholarship you received and the amount of money allocated to your child (in the comment box below).

When paying for camp, please deduct the cost of the scholarship from the total amount.
Comments
Total

$0.00

I would like to pay today:Full amount$0.00 minimum$
Yes, I'd like to donate the cost of processing this transaction by adding 3.4%

Payment Options

Credit Card Venmo

Postal / Zip Code

Country

If you would like to sponsor a child who may need additional support, please donate here:

$50$75$100
Should be Empty:

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