Registration

KidZone Holiday Camp 2010

Online Registration

Note: Full Day Camp 8:30 to 5:00pm Half a day Camp 8:30 to 2:30pm

Mother's Name *
Father's Name
Student's Name
Student's Age
Home Address
City
Zip
Phone *
Emergency Phone *
e-mail *
2nd e-mail
Name of Referral
Allergies *	Yes No
Choose Program	April 12 Full Day (48.00 USD) April 12 Half Day (38.00 USD) April 13 Full Day (48.00 USD) April 13 Half Day (38.00 USD) April 14 Full Day (48.00 USD) April 14 Half Day (38.00 USD) April 15 Camp Full April 15 Camp Full April 16 Camp Full April 16 Camp Full Complete Week Full Day (228.00 USD) Complete Week Half Day (181.00 USD) Total:

Mother's Name *
Father's Name
Student's Name
Student's Age
Home Address
City
Zip
Phone *
Emergency Phone *
e-mail *
2nd e-mail
Name of Referral
Allergies *
Choose Program

If you prefer sending payment by mail. Fill the above form, Click on "Register & PayOnline" and send us payment directly. Remember that you are not register until payment is received.