Dante Fascell - Spring Break Registration

Dates Interested in Attending: *
------------------ Spring Break Camp Week #1: April 6th to April 10th Spring Break Camp Week #2: April 13th to April 17th Both weeks of Spring Break Camp

Camper's Name: *


Camper's Date of Birth: *


Skill Level *
Total Beginner Some Experience Intermediate/Advanced

Register for the Full Week:
-------------- Full Week #1: $200 Full Week #2: $200 Full Weeks #1 and #2: $400

Days Attending (Use this option if you will not be attending the full week): Daily Rate: $45

Week 1:

Monday (3/29)

Tuesday (3/30)

Wednesday (3/31)

Thursday (4/1)

Friday (4/2)

Week 2:

Monday (4/5)

Tuesday (4/6)

Wednesday (4/7)

Thursday (4/8)

Friday (4/9)

Parent's Name: *


Email: *


Parent's Home Phone Number: *


Parent's Cell Phone Number: *


Emergency Contact Name: *


Emergency Contact Phone Number: *


Additional Information/Comments


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