Summer Camp Registration

Please fill out this to register for St. Cuthbert School Summer Camps and click submit.

Parents Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Child's Name

*

Child's DOB

*

Child #2 Name

Child #2 DOB

Does the child have any allergies?

*

Please select all that apply.

Yes No

If yes, please explain.

Camp Session

*

Please select all that apply.

Session 1 (June 10-14) Session 2 (June 17-21) Both Session 1 & 2

Please Upload Health Insurance Information

*

Upload (8MB)

Payment Information

If paying by cash or check, please choose the Cash/Check $0 option in the drop down menu.

Payment

One Session ($140) Two Sessions ($280) One Session for Two Children ($280) Two Sessions for Two Children ($560) Pay by Cash/Check ($0 )

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this to register for St. Cuthbert School Summer Camps and click submit.

Close