Which session(s) are you hoping to sign up for? *

July 21-24 (Art Focus)

July 28-31 (Nature Focus)

Child's Name *

First Name

Last Name

Child's Date of Birth *

Must be between the ages of 3 and 5 at the time of the program (Ages 2 years 9 months-3 years will be considered on a case-by-case basis)

MM

DD

YYYY

Parent/Guardian 1 *

Name

First Name

Last Name

Phone *

(###)

###

####

Parent/Guardian 2 (Optional)

Name

First Name

Last Name

Phone

(###)

###

####

Which parent/guardian should I contact? *

Parent/Guardian 1

Parent/Guardian 2