Parent/Guardian #1 Full Name * First Name Last Name Contact Number * (###) ### #### Relationship to Child * Parent/Guardian #2 Full Name First Name Last Name Contact Number (###) ### #### Relationship to Child Email * Emergency Name & Phone Number (other than parents) * Names of people authorized to pick up your child in addition to parents * Child Name * First Name Last Name Date of Birth * MM DD YYYY How old is your child? * Which day(s) would you like your child(ren) to attend? * * Full week for $350 or $75 for a single day *Camp is currently full, sign-up to be on waitlist only* Full Week March 10 March 11 March 12 March 13 March 14 Does your child have any allergies that we should be aware of? * How did you hear about us? * Instagram Whatsapp/ Facebook groups XHS Referral/Others Referral (Please indicate who referred you) *only new referrals get 10% off* Additional comments/questions Thank you for your registration.! We will send an email confirmation within 48 hours. Sign Up Form*CAMP IS FULL, Sign-up to be on waitlist only* Bring a sibling or a friend for 10% off *Must be new referral for a friend discount*
