CAS Summer Camp Registration Forest Glen Location

Please fill in the following information

Best Email Address:

Other Email Address:

Child's First name: Child's Last name:

3 day or 5 day program:

Date of Birth: Gender:

Address: APT #: City: Zip:

Summer Camp Location:

Current Grade (2023-2024):

Parent/Guardian Name: Parent/Guardian Number:

Parent/Guardian Name: Parent/Guardian Number:

Please initial each week you are planning to attend.

Week 1 - 6/12
Week 2 - 6/17
Week 3 - 6/24
Week 4 - 7/01
Week 5 - 7/08
Week 6 - 7/15
Week 7 - 7/22
Week 8 - 7/29

Fees are: $50 reg/supply fee 5 day 205 $1st child, $195 2nd child 3 day $145 1st child, $138 2nd child.

Payments must be made with cash or Zelle, please send all summer Zelle payments to 954-729-5663. In order for your payment to be applied, YOU MUST INCLUDE CAMP LOCATION AND CHILD'S NAME.

Signature of parent/guardian: Date: