Summer Rec Registration

Summer Recreation 2022 Registration Form
June 6th through July 14th, Monday through Thursday each week
10 AM to 2 PM

Available for: School Children Ages 5-13
Registration Fee: $190 for first child, second child $180, third child $165
*Scholarships available, if needed.
(Special Fee of $20 per day available for enrolled children's guests and occasional visitors.)

* Indicates required field

Child's Name *

First

Last

Child's Birthdate (mm/dd/yyyy) *

Parent or Guardian Name *

First

Last

Parent/Guardian Email *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Phone Number *

Work Phone Number *

Preferred phone *

Cell Home Work

Contact other than Parent *

Contact's relationship to child *

School child will be attending 2022-2023 *

Child's grade in 2022-2023 school year *

Home Church or place of worship (if one) *

Allergies & Medications *

Optional T-Shirts: Please list below the names and sizes for Summer Rec T-shirts. Each shirt is $10 and can be paid at time of registration or by June 24th at the latest. The shirt comes in children's sizes as well as adult.

Name to go on shirt *

T-shirt size *

Submit

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