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West Miramar & West Pines FL - Weekly Pay 2024
CB Smith Corner Pick up (corner of flamingo & Miramar Pkwy)
Silver Lake North Park
Miramar Regional Park
Week Selection
*
Please select
Week 1 - Mon June 10 - Fri June 14
Week 2 Mon June 17 - Fri June 21
Week 3 - Mon June 24 - Fri June 28
Week 4- Mon July 1 - Fri July 5
Week 5 - Mon July 8- Fri July 12
Week 6 - Mon July 15 - Fri July 19
Week 7 - Mon July 22- Fri July 26
Week 8- Mon July 29 - Fri Aug 2
Week 9 - Mon Aug 5 - Fri Aug 9
Week 10 - Mon Aug 12 - Fri Aug 16
Drop Off Location
*
Please select
Miramar Regional Park
Silver Lake North Park
CB Smith Par
Week 4- Mon July 1 - Fri July 5
Week 5 - Mon July 8- Fri July 12
Week 6 - Mon July 15 - Fri July 19
Week 7 - Mon July 22- Fri July 26
Week 8- Mon July 29 - Fri Aug 2
Week 9 - Mon Aug 5 - Fri Aug 9
Week 10 - Mon Aug 12 - Fri Aug 16
How Many Children are Attending?
*
Please select
1 Child
2 Children
3 Children
Child #1 Name
First
Last
Child #1: Registration Status
Please select
First Time - Need to Pay Reg Fee ($50)
Already Paid Reg Fee ($0)
1 Child: Camp Week Duration
Please select
1 Child: Full Day (8:00am-6:00pm)
1 Child: Morning Half Day (8:00am-12:30pm)
1 Child: Afternoon Half Day (12:30pm-6:00pm)
1 Child: Only 1 Day in the Week
1 Child: 2 Days
1 Child: 3 Days
Child #2 Name
First
Last
2 Children: Registration Status
Please select
First Time - Need to Pay Reg Fee ($100)
Already Paid Reg Fee ($0)
2 Children: Camp Week Duration
Please select
2 Children: Full Day (8:00am-6:00pm)
2 Children: Morning Half Day (8:00am-12:30pm)
2 Children: Afternoon Half Day (12:30pm-6:00pm)
2 Children: Only 1 Day in the Week
2 Children: 2 Days
2 Children: 3 Days
Child #3 Name
First
Last
3 Children: Registration Status
Please select
First Time - Need to Pay Reg Fee ($100)
Already Paid Reg Fee ($0)
3 Children: Camp Week Duration
Please select
3 Children: Full Day (8:00am-6:00pm)
3 Children: Morning Half Day (8:00am-12:30pm)
3 Children: Afternoon Half Day (12:30pm-6:00pm)
3 Children: Only 1 Day in the Week
3 Children: 2 Days
3 Children: 3 Days
What Day (s) will you be attending?
Monday
Tuesday
Wednesday
Thursday
Friday
Mothers or Fathers Name
*
First
Last
Cell Number
*
###
-
###
-
####
Email
need for payment confirmation
Do you Need ALM as an Primary Insurance for the Week
*
Yes - I want ALM Insurance as Primary ($10 family)
No - Ill use my Own Insurance as Primary ($0)
Do you Need an additional ALM Shirt?
*
Yes - I want an additional ALM Shirt($10)
No - I do not need an additional ALM Shirt ($0)
Total
$2.25
