Registration

Thankful Turkey Camp 9 a.m. - 1 p.m. Ages 4-up Must bring a sack lunch, snack and water bottle. All Campers must be potty-trained

Event:

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End Date/Time:

Fee per Student:

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Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:*	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *

Students entered below will be added to your family's account

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Grade Level:
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

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Credit Card Verification:

Card Number:

Name as it appears on card:

Nickname:

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Exp Year:

Address Line 1:

Address Line 2:

City:

State: Zip:

eCheck/Bank Draft:

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Bank Routing Number:

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Your Account Name:

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