Camper Information Dates: June 22- July 17, 2026 Monday - Friday Before care 8:30am - 9am $10 a day/$50 a week After care 3:30pm - 5pm $20 a day/$100 a week Number of Children Registering for Early or After Care Camper 1 Name* First Name Last Name Date of Birth* Month Day Year Grade My child/children will be attending:* Before CareAfter Care Attending Before Care:* DailyWeekly Attending After Care:* DailyWeekly Child 1: My child/children will be attending 8:30am-9am:* June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17 Child 1: My child/children will be attending 8:30am-9am:* Please select all that apply: Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17 Child 1: My child/children will be attending 3:30pm-5pm:* Please select all that apply: Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17 Child 1: My child/children will be attending 3:30pm-5pm* June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17 Camper 2 Name First Name Last Name Date of Birth Month Day Year Grade My child/children will be attending:* Before CareAfter Care Attending Before Care:* DailyWeekly Attending After Care:* DailyWeekly Child 2: My child/children will be attending 8:30am-9am:* June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17 Child 2: My child/children will be attending 8:30am-9am:* Please select all that apply: Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17 Child 2: My child/children will be attending 3:30pm-5pm* June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17 Child 2: My child/children will be attending 3:30pm-5pm:* Please select all that apply: Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17 Camper 3 Name First Name Last Name Date of Birth Month Day Year Grade My child/children will be attending:* Before CareAfter Care Attending Before Care* DailyWeekly Attending After Care* DailyWeekly Child 3: My child/children will be attending 8:30am-9am:* June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17 Child 3: My child/children will be attending 8:30am-9am:* Please select all that apply: Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17 Child 3: My child/children will be attending 3:30pm-5pm* June 22June 23June 24June 25June 26June 29June 30July 1July 2July 3July 6July 7July 8July 9July 10July 13July 14July 15July 16July 17 Child 3: My child/children will be attending 3:30pm-5pm:* Please select all that apply: Week 1: June 22-26Week 2: June 29-July 3Week 3: July 6-10Week 4: July 13-17 Parent Information Father's Name First Name Last Name Cell Phone Area Code Phone Number E-mail Mother's Name First Name Last Name Cell Phone Area Code Phone Number E-mail Payment Total $0.00 Yes, I'd like to donate the cost of processing this transaction by adding 2.5% Payment* Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration Year Notes Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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