Summer Day Camp REGISTRATION

Parent's Name*

Email*

Phone Number*

How many children are attending?*

Child 1: Name*

Child 1: Age*

Child 1: Any Allergies?

Anything we should know about your child(ren)?

Emergency Contact Name*

Emergency Contact Cell*

I give Gather permission to take & share photos of my child. (We will not share names)*

Total

$50.00

Facebook Event:

Billing Information

Name*

Payment Method

Credit Card*

Address*

Email*

Confirm Email*

Phone Number*