Please note, an additional 50% payment is required with registration. 

We must have your total camp fee the Friday before your registered

camp session to confirm your child's place in camp.

Information

Camper's Name: ________________________________________________

DOB: ___/___/_______      Age:________      M / F

Grade level (entering):_________             T-shirt size (Youth):   S     M     L     XL

Contact Parent/Guardian: __________________________________________

Address: _______________________________________________________

City:__________________________  State:________  Zip code: ___________

Day Ph.: _____________  Cell Ph.:_____________  Evening Ph.:____________ 

Emergency Contact:_______________________  Relationship:______________

Day Ph.: _______________________  Cell Ph.:__________________________ 

Please Circle       Friend of the Museum?        Yes                    No

Please Circle      Registering for Week:       1      2      3      4      5      6      7      8      9

Please Circle     Extension Day Camp:        Mon.       Tues.       Wed.      Thurs.       Fri.

Fees

Number of camp sessions_______ X fee_________=____________

Plus Before/After Camp                                                    +____________