Registration Form

 

Student First Name: _____________________________________________

Student Last Name: _____________________________________________

Student Date of Birth; YYYY-MM-DD:  ________________________________

Parent First Name:  _____________________________________________

Parent Last Name:  ______________________________________________

Home Phone:  _________________________________________________

Mobile Phone: _________________________________________________

Email:  ______________________________________________________

Message:  _________________________________________________________________________________

 ________________________________________________________________________________________

Select the week (s) when you want to come

June 12 - June 16 

June 19 - June 23

June 26 - June 30

July 10 - July 14 

July 17 - July 22 

July 24 - July 28

July  31 - August 4

August 7 - August 11

August 14 - August 18

August 21 - August 25

 

All the information supposed to be sent to me.