Camper Information
Camper's Name: E-Mail: Street Address: City: State: Zip Code:
Program Age Level
Junior (6-8) Senior (9-12) Teen (13-17)
Parent Information
Parent's Name: Street Address: City: State: Day-Time Phone: Cell Phone:
Session Information (Please select one of the following date/course # combos)
June 23-27, 2008 Junior 90017 June 23-27, 2008 Senior 90018 June 23-27, 2008 Teen 90019
July 7-11, 2008 Junior 90001 July 7-11, 2008 Junior 90016 July 7-11, 2008 Senior 90002
July 14-18, 2008 Senior 90005
July 21-25, 2008 Junior 90006 July 21-25, 2008 Junior 60017 July 21-25, 2008 Senior 90007
July 28-August 1, 2008 Junior 90008 July 28-August 1, 2008 Senior 90009 July 28-August 1, 2008 Teen 90010
August 4-8, 2008 Junior 90011 August 4-8, 2008 Junior 90018 August 4-8, 2008 Senior 90012
August 11-15, 2008 Junior 90013 August 11-15, 2008 Senior 90014 August 11-15, 2008 Teen 90015
Payment Information
Session Cost: $225.00
Qualified Sibling Discount (5%): -$11.25 (if applicable)
Sibling's Name:
PLEASE REMEMBER TO REGISTER ALL SIBLINGS SEPARATELY
Total Paid
$225 (select this if you are registering just one camper) $213.75 (only select this if you provided the name of a co-registered sibling above)
