Parent’s Name___________________________
Date and Amount of Payment __________________
(6 classes - $132, 12 classes - $245)
Payment Type: Check Number_________________
Cash Receipt
Number____________
e-mail address____________________
emergency phone
number_____________________
1st – 3rd Grade CAMP DATES (check chosen dates)
Week Month Tues. Thurs.
#1 June 13_____ 15_____
#2 20_____ 22_____
#3 27_____ 29_____
Vacation Week
#4 July 11_full___ 13_____
#5 18_full___20_full_
#6 25_full___27_full____