Summer Camp Registration

Child's Full Name

Child's Birthdate

Female

Male

Address

Mother's Name

Mother's Phone

Mother's Email

How did you here about us ?

Please describe any physical conditions we may need to be aware of (vision, hearing, speech, movement etc.)

Father's Name

Father's Phone

Father's Email

Does your child have any known allergies or food sensitivities?

Please describe any supplemental learning or behavioral intervention your child has received.

Is there anything else you would like us to know about your child?

Hidden Talent Art Camp July 10th-14th ($50 deposit + $350)

Herbal Apothocary Camp July 17th-21st ($50 deposit + $350)

Improv & Theatre Camp July 24th-28th ($50 deposit + $350)

Sport Games & Fitness Camp July 31st - August 4th ($50 deposit + $350)

Please enter the total amount of the camp deposits you would like to sign up for (eg 1 camp = $50 2 camps = $100 )

See You This Summer!

Juniper Tree