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  • Camp Broadway Summer Camp Registration Form:: June 20 - 24, 27 - July 1, 2016 (Grades 4 - 8)

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    This document is a registration form for Camp Broadway Summer Camp from June 20th to July 1st for grades 4th through 8th. It requests the student's name, age, grade, parent's name(s), address, phone number, email, emergency contact, and any medical conditions or other information. Payment options include PayPal, cash, check, credit/debit with a one-time payment of $200. Additional costs include $15 for a t-shirt and $10 discount for Greenwood students. The parent must sign and the director will also sign with the total amount due provided.

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    This document is a registration form for Camp Broadway Summer Camp from June 20th to July 1st for grades 4th through 8th. It requests the student's name, age, grade, parent's name(s), address, phone number, email, emergency contact, and any medical conditions or other information. Payment options include PayPal, cash, check, credit/debit with a one-time payment of $200. Additional costs include $15 for a t-shirt and $10 discount for Greenwood students. The parent must sign and the director will also sign with the total amount due provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    278 views1 page

    Camp Broadway Summer Camp Registration Form:: June 20 - 24, 27 - July 1, 2016 (Grades 4 - 8)

    Uploaded by

    api-299759325
    This document is a registration form for Camp Broadway Summer Camp from June 20th to July 1st for grades 4th through 8th. It requests the student's name, age, grade, parent's name(s), address, phone number, email, emergency contact, and any medical conditions or other information. Payment options include PayPal, cash, check, credit/debit with a one-time payment of $200. Additional costs include $15 for a t-shirt and $10 discount for Greenwood students. The parent must sign and the director will also sign with the total amount due provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    Camp Broadway Summer Camp Registration Form:

    June 20th-24th, 27th- July 1st, 2016 (Grades 4th-8th)


    STUDENTS NAME:___________________________________________________________
    AGE/GRADE: _____________________
    PARENT(S) NAME(S): ___________________________________________________________
    ADDRESS: _________________________________________________________________
    _________________________________________________________________
    PHONE: ________________________________________________
    EMAIL(S): _________________________________________________
    EMERGENCY CONTACT: ____________________________________________
    DO YOU SUFFER FROM ANY ALLERGIES, ILLNESS, DISABILITY, OR OTHER MEDICAL CONDITIONS? IF
    YES, PLEASE DETAIL BELOW:

    ANYTHING ELSE WE NEED TO KNOW?

    METHOD OF PAYMENT (CIRCLE) (ONE TIME PAYMENT OF $200)


    PAY PAL

    CASH

    CHECK

    CREDIT/DEBIT

    *PLEASE MAKE ALL CHECKS PAYABLE TO CHELSEA LENTZ*


    PAYPAL PAYMENTS CAN BE SENT TO CHELSEA@UPSTREAMACTINGGROUP.COM
    T-SHIRT SIZE (IF DESIRED) ($15): ________________ SIZE: _________________
    GREENWOOD STUDENT DISCOUNT ($10) ___________
    PRE-ENROLLEMENT (RESERVE MY SPOT, I WILL COMPLETE PAYMENT BY 06/01/2016) ($50): ___________
    TOTAL: _____________________
    SIGNATURE OF PARENT:
    __________________________________

    SIGNATURE OF DIRECTOR:
    ___________________________________

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