Mid Winter Camp - Brooklyn

Mid Winter Camp - Brooklyn

Mid Winter Camp Registration 2017 - Brooklyn

*
Denotes required field


Child Information
First name*
Last name*
Date of birth (mm/dd/yy)*
P.S. number*
Room number
Grade number*
Allergies or medical concerns
Home Address*
City/State/Postal Code*
Home phone number*
Parent's Cell phone*
   

Payment information
Released Time Winter Camp $150.00
Released Time Winter Camp- with early Discount
(before December 10)
$125.00
Sign up for Bus Transportation Service Yes No
Method of Payment*
   
Credit card number
Expiration date
Name on Card
CVV (3-4 digit code on card)

Checks can be made out to : Released Time Program, 824 Eastern Parkway, Brooklyn, NY 11213


Email for confirmation*
   
I heard about Released Time Winter Camp from
Comments
   

 

 

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