All Fired Up!

Date MM / DD / YYYY
Parent Name First Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Home Phone ### - ### - ####
Cell Phone ### - ### - ####
Child Name & Age * First Last
List age after last name
Child Name & Age * First Last
List age after last name
Allergies
Yes No
Type of Allergy or Other Concerns
Medications:
Emergency Contact Name First Last
Emergency Contact Phone ### - ### - ####
Choose One Week, 2 Weeks or More
Week 1 - July 13th thru July 17th Week 2 - Aug 10th thru Aug 14th
Cost

A deposit of $100.00 is required to hold your child’s spot. Balance is due on the first day of camp.
The cost is $225.00 including tax per week with a 10% discount for siblings.(2nd child at $202.50 iincluding tax) Early registration is recommended.
Cancellation Policy

Cancellation policy: If the unfortunate situation occurs that we must cancel any session that you have signed up for due to lack of enrollment, a full refund will be issued. Due to careful planning and project preparation, refunds cannot be issued to any customer cancelling a session with less than two week’s notice.
To pay your required deposit of $100.00 per child, click on the Paypal link below this form. Registration is not accepted without payment.
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