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Summer Camps 2019 Online Registration and Payment
Todays Date
*
(mm/dd/yyyy)
Contact Information
Childs Name
*
First Name
Last Name
Age
*
Parent(s) Name
*
First Name
Last Name
Phone
*
Email
*
Verify Email
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Allergies
*
Type NONE if your child has no known allergies.
Camps
*
Garden Camp June 24-27
Garden Games July 15-18
Animals and Insects July 22-25
Garden Mysteries July 29-Aug 1
Payment Information
Payment Due
*
$225
-
1 camp
$450
-
2 camps
$675
-
3 camps
$900
-
4 camps
Consent-Liability Release Form
*
Will Print and Mail In
Consent-Liability Release Form
Please print your name and sign this Acknowledgement of Policies, Consent and Release of Liability Form. Send to: Classroom in Bloom, PO Box 1264, Winthrop, WA 98862.