2023 SUMMER CAMP
Questions marked by * are required.
1. Camper's Name(s) (First, Last) (if multiple, list by age - youngest to oldest) *
2. Date(s) of Birth: (mm/dd/yy) (youngest to oldest) *
3. Camper's age(s) as of 6/1/2023:(youngest to oldest) *
4. Camper's Grade(s) in August 2023: (youngest to oldest) *
5. Street Address: *
6. City, State, Zip *
7. Guardian Name (First, Last): *
8. Guardian Relationship to Camper: *
9. Guardian Cell Phone Number: *
10. Guardian E-Mail Address: *
11. Name(s) and cell phone number(s) of people other than guardian who may be bringing your child to and from camp:
12. Please tell us how you heard about our Summer Camp: *
13. Allergies: Please list any allergies your child may have:
14. Dietary Restrictions: Please list any dietary restrictions your child may have:
15. Conditions: Please list any chronic illness or medical conditions your child may have as well as any medications your child may be taking and the reason for taking them. (NOTE: we do not administer ANY medications):
16. Special Needs: In order for our staff to ensure your child has a happy experience at summer camp, please share any special needs your child may have - e.g., learning disabilities, limitations, dislikes, fears etc...
17. The charge for Half Day/Full Week is $125; The charge for a Full Day/Full Week is $225); The charge for a Half Day/Partial Week (or by the day) is $30/day; The charge Full Day/Partial Week (or by the day) is $55/day. Please Choose: *
  • Morning: (Mon-Fri 8AM-12PM) $125/week
  • Afternoon: (Mon-Fri 12PM-4PM) $125/week
  • Full Day: (Mon-Fri 8AM-4PM) $225/week
  • Partial Week Morning: ($30/day)
  • Partial Week Afternoon: ($30/day)
  • Partial Week Full Day: ($55/day)
18. Please indicate your weeks below. Partial weeks are an option - choose your weeks 1st and then your days (in #23): *
  • All 9 Weeks
  • Week 1: June 5 – 9
  • Week 2: June 12 – 16
  • Week 3: June 19 – 23
  • Week 4: June 26 – 30
  • Week 5: July 3 – 7 (NO CAMP 7/4 - raincheck for another day!)
  • Week 6: July 10 – 14
  • Week 7: July 17 – 21
  • Week 8: July 24 – 28
  • Week 9: July 31- August 4
19. Which day(s) of the week is your camper coming? *
  • Monday-Friday (5 days)
  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
20. If necessary, please use the box below to give more information about the days and dates you are enrolling for: (Questions? Call us! 239-261-2606)
21. We offer before care (7:30AM-8:00AM) and after care (4:00PM-4:30PM) for a flat fee of $10 per child per day. Please Choose:
  • I will need before/after care
  • I will not need before/after care (skip to #25)
22. Before/After care must be prearranged and paid for in advance. The initial fee is collected when you register (along with payment for your first week of camp) and afterwards will be charged along with your weekly payments. If you wish to discontinue before/after care a full week’s notice is required.
  • OK
23. Your request for before/after care means we are arranging for counselors to arrive early and stay late. Therefore, there are no refunds or credits for any before/after care payments.
  • OK
24. In the box below (if needed) please provide more details about your before/after care needs.
25. First Payment: In order to hold your child's place in camp the 1st week’s camp fee must be paid at the time of registration. Please select one of the payment options below. *
  • Option #1: I am including my credit/debit card information, please charge my card in advance for all of the days/weeks I have indicated.
  • Option #2: Option #2: I am including my credit/debit card information, please charge my card for the 1st week of camp (after that please charge my card on the Monday of each week we attend).
  • Option #3: I am including my credit/debit card information, please charge my card for the 1st week of camp (after that we will pay in person on the Monday of each week we attend.
  • Option #4: I will come in or phone in my payment.
  • Option #5: I will pay my camp fees using the PayPal link on the 'Camp Fees' page.
26. If paying weekly, payments are made in advance of the week ahead on your camper’s 1st day of attendance for that week. Please type your initials in the box below as an acknowledgement of this policy. *
27. Your camp registration will not be processed and a place will not be held for your child until payment for the first week of camp is made. *
  • OK
28. Camp fees are non-refundable and we do not offer refunds or prorates for absences. At our discretion, we may issue a credit for future participation in our Summer Camp, Dance or Tumbling programs. Please type your initials in the box below to indicate your acknowledgement of this policy. *
29. IMPORTANT: Our camp fills up, so your registration may mean that we are turning others away or placing them on a waiting list. If you do not show up or fail to pay for a day/week that you registered for we will assume you are not coming back and we will give your child’s spot to the next child on the waiting list. Please type your initials in the box below as an acknowledgement of this policy. *
30. Card Number:
31. Expiration date:
32. CVV Code: (3 or 4 digit # from the back of the card):
33. Billing Zip Code:
34. When you click submit you will be automatically directed to The LIABILITY WAIVERS. *
  • Ok