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PROSPECT PARK

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School Holiday Camp

Child's First Name*

Child's Last Name*

Email*

Phone*

Child's Date of Birth*

Month

Day

Year

Address*

Allergies/health condition*

Parents Full Name

Caregiver Full Name & Phone Number

School Holiday Camp*

January 16th

January 19th

March 20th

April 2nd

April 3rd

April 6th - 10th

May 25th

May 27th

June 4th

June 5th

June 19th

Extended Hours

Early drop-off (9 am)

Late pick-up (4 pm)

Late pick-up (5 pm)

NOTES:

Signature

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I agree to the terms & conditions (all payments must be made before the start date. We do not offer credits, cancellations, or refunds)

Call

(+1)9172043632

Email

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