Summer Registration – Summer Stage

We offer 50 dollar family discounts. (25 Dollar for the one week session)

Please Choose Your Sessions *

Child's Name *

First

Last

Age

Email *

Name of Parent or Guardian *

First

Last

Phone Number

T-Shirt Size

Additional Parent or Guardian

First

Last

Phone Number

Street Address *

Town

Zip Code

Emergency contact

First

Last

Emergency Contact Phone Number

ALTERNATIVE PICK UP

Does your child require any medication during the program day, or have any special considerations we should be aware of?

Additional comments

Photo Acknowledgement *

I acknowledge my child may be photographed during the program day for use in Summer Stage promotion.

Please Check

Phone