contact2

CAMP REGISTRATION INFO IS

STUDENT NAME

ADDRESS

TEL#

EMAIL#

AGE

M/F

CLASS REGISTERING FOR

SESSION A - $1,150SESSION B - $1,450SESSION C - $ 975SESSION D - $500ALL DAY - SESSION A & B - $2,700

PAYMENT METHOD

CHECKCASHVISA/MASTER/DISCOVER

CC#

EXP. DATE

CVC#

AMOUNT TO BE CHARGED