The Fun Starts Here! Register for Child Care/Camp Today!

Please enter all information in Mixed case (i.e. John Smith) Fields in red indicate a required field.
Child's First Name
Child's Last Name
Date of Birth
Age
Gender	Male  Female
Grade
Mailing Address
Mailing Address 1
Mailing Address 2
City
State
Zip/Postal Code
Parent(s)/Guardian(s) Information
Parent/Guardian First Name
Parent/Guardian Last Name
Mailing Address 1 (if different)
Mailing Address 2 (if different)
City
State
Zip/Postal Code
Phone Number 1
Phone Number 2
Email Address
Additional Parent/Guardian Name
What Are You Registering For?	Before/After School Care (Kids Express/Child Care)  Adventure Club  Summer Day Camp  Kamp Kermit  Safety Camp/Safety Camp Jr.
Before submitting this form, please click on the link below to move the contents of box "A" into box "B" leaving the first box empty. A: B: Click to Move