AESV Summer Camp

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Parent Name*

First Last

Phone*

Email*

Child (1) Name*

First Last

Child (1) Age*

Child (2) Name

First Last

Child (2) Age

Child (3) Name

First Last

Child (3) Age

How will you be enrolling?*

Daily ($40 per day)

Weekly ($185 per week)

Does your child(ren) have any dietary restrictions/allergies? (if yes, explain below)*

Questions, comments, concerns?