EmailMe Form - 2023 Middle School Reading BOOST Camp

Please note that payment has been disabled on this form.
You may notify the owner and continue to submit the form.

Child's grade
This camp is only intended for incoming 6th and 7th graders.
Child's Name *
First Last
Gender *
Male
Female
Child's Birthday *
MM / DD / YYYY
Parent/Guardian #1 *
First Last
Parent/Guardian #1 Relationship to Camper *
Parent/Guardian #1 Cell *
### - ### - ####
Parent/Guardian #1 Work Phone
### - ### - ####
Parent/Guardian #1 Place of Business *
Parent/Guardian #1 Email *
Is there a second Parent/Guardian to add?
Yes
No
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