Summer Camp Registration Form

Registration for Granite Gorge Summer Camp 2017

Child's Name*
Age*
D.O.B
Medical/Physical Needs*
Address
Street Address City State ZIP Code
Parent or Guardian*
First Last
Must be 18 years or older
Phone*
Email*
Emergency Contact*
First Last
Phone*
Relationship to Student*
Select a Session or Week
Select a Session*
- Session One (First 4 Weeks - No Camp July 4th)
- Session Two (Second 4 Weeks)
- Full Summer (All 8 Weeks)
- One Week
Select week (for one week option)
After Care (4:30-5:30) Monday- Thursday
- Per Week
- 4 Weeks
- 8 Weeks
Total
$0.00
Type Name*
First Last

Select a Session or Week