Registration

1 openings left in this event!

'Imagine That Camp" 4-8 year olds Nov 20 2021

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

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

	Address: *
	City: *	State/Prov: * Postal Code: *

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

Questions/Options:


Are you inviting a friend to register with you? If yes, then the cost is just $30 per person. Please enter your friend's name here. Once you have both registered the discount will be applied.

Additional Information:

Other Questions/Comments:

Credit Card Verification:

Card Number: *

Name as it appears on card: *

Nickname:

Card Expiration Month: *

Exp Year: *

Address Line 1:

Address Line 2:

Country: *

City:

State/Prov: * Postal Code:*