Registration Deadline May 17, 2024

Pre Registration is Required

PLEASE COMPLETE A SEPARATE REGISTRATION FORM FOR EACH CHILD

Child's First Name *

Child's Last Name *

Address *

City *

State *

Zip code *

Age: years *

Birthdate * +

Gender *

Male

Female Female

Does the child have any allergies? If so, please explain.

School *

Grade going into school this fall *

T Shirt Size *

Please list other family members who are also attending this camp
(separate registration still required)

One unusual fact or trivia about your child to use in group therapy
(i.e. She was born on St. Patrick's Day, his Dad is serving in Iraq, he plays football, etc)

Registration Deadline May 17, 2024

Pre Registration is Required

**PLEASE COMPLETE A SEPARATE REGISTRATION FORM FOR EACH CHILD**

PLEASE COMPLETE A SEPARATE REGISTRATION FORM FOR EACH CHILD