Summer registration

Child Name *

First Name

Last Name

Date of birth *

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Select Days *

Monday

Tuesday

Wednesday

Thursday

Friday

Select Weeks *

* Closed on Friday, July 4 | ** Closing at noon on Friday, August 15

(1) Week of June 23

(2) Week of June 30 *

(3) Week of July 7

(4) Week of July 14

(5) Week of July 21

(6) Week of July 28

(7) Week of August 4

(8) Week of August 11 **

Parent Name *

First Name

Last Name

Parent Phone *

(###)

###

####

Parent 2 Printed Name

First Name

Last Name

Parent 2 Phone

(###)

###

####

Date *

MM

DD

YYYY