Salvation Army Summer Day Camp Registration Question Title * 1. First and Last Name of Main Contact Question Title * 2. Email Address Question Title * 3. Phone Number Question Title * 4. Name and And Age of each child attending Day Camp Child 1 Child 2 Child 3 Child 4 Question Title * 5. Which weeks will your child(ren) be attending. June 7 - 11 June 14 - 18 June 21 - 25 June 28 - July 2 July 6 - 9 July 12 - 16 July 19 - 23 July 26 - 30 Question Title * 6. The weekly rate is $200. Do you need a partial scholarship for your child(ren) to attend. Yes No Question Title * 7. If your child has special needs or requires speical accomindations, please list those needs. Question Title * 8. Are you interested in an After School Program in the Fall? Yes No Question Title * 9. What is the TShirt size of your child(ren) Name & Size Name & Size Name & Size Name & Size Done