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Camper Name: ____________________________________ Age at start of camp: ________ Address: __________________________ City: _______________ State: ______ Zip: ______ Parent(s)/Guardian(s) ___________________________________________________________ Address (if different than above) _________________________________________________ Home Phone:___________ Work: ____________ Cell: _____________ E-mail: ___________ Name of current school:________ _________________________________________________ Child's likes and dislikes: _________________________________________________________ ________________________________________________________________________________ Medical problems: _______________________________________________________________ Camp sessions - circle date(s): Breakfast and lunch included on both sessions. Session A June 9 -13 1/2 day - 8:00am - 12:00 Full day - 8:00am - 2:00pm Session B June 16-20 1/2 day - 8:00am - 12:00 Full day - 8:00am - 2:00pm
To register: 1. Print this form out. 2. Return this form and full tuition plus $30.00 non-refundable deposit by June 6th. Please submit one application per camper. Mail to : Sara O'Neal Post Office Box 13865 Alexandria, Louisiana 71315 |
For problems or questions regarding this web contact
James Drayton.
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