Name
Date of Birth
Name
Email
Phone
Address
Name (Contact 1)
Phone
Name of second child
Date of Birth (second child)
Current School Grade
Do any of your registrants have any allergies, chronic illness, or medical conditions?
Are you interested in sponsoring a child to come to CAMP SHINE?
Morning Summer Sessions ($474.05 per session per child reflects 5% discount)
Morning Summer Sessions ($948.10 per session for 2 children reflects 5% discount)
Morning Summer Sessions ($1896.20 per session for 4 children reflects 5% discount)
Willa Ljungkull
2/20/2015
First Grade
Session 2 - June 13-16 - $ 424.15
Camila Silva
8/7/2013
Yosa Silva
yosafabian@hotmail.com
+19253830395
2719 benson cr Martinez, CA 94553 US
Yosa Silva
(925) 383-0395
Third Grade
No
No thanks.
Session 5 - July 11-July 14 - $ 424.15
Ellis Roberts
8/10/2015
Virginia and Tyson Roberts
virginiaroberts12@gmail.com
+19258762966
1148 Heavenly Drive Martinez, CA 94553 US
Virginia Roberts
(925) 876-2966
First Grade
No
No thanks.
*Bonus Session - May 31 - June 3 - $ 424.15
Ellis Roberts
8/10/2015
Virginia and Tyson Roberts
virginiaroberts12@gmail.com
+19258762966
1148 Heavenly Drive Martinez, CA 94553 US
Virginia Roberts
(925) 876-2966
First Grade
No
No thanks.
*Bonus Session - May 31 - June 3 - $ 424.15
Aubrey Rulifson
6/21/2014
Megan MacKenzie
mackenziemegan89@gmail.com
+19254371223
1220 Gregory Ave Martinez, CA 94553 US
Megan MacKenzie
(925) 437-1223
Second Grade
No
No thanks.
Session 2 - June 13-16 - $ 424.15
J D
9/13/2015
J C
jnnfr777@gmail.com
+19258641449
764 shell ave #3 Martinez, CA 94553 US
J C
(925) 864-1449
Kindergarten
No
No thanks.
Session 6 - July 18-21 - $ 424.15 Session 7 - July 25-July 28 - $ 424.15
Journey Davis
9/13/2015
Jennifer Cullum
jnnfr777@gmail.com
+19258641449
764 shell ave #3 Martinez, CA 94553 US
Kindergarten
No
No thanks.
Session 3 - June 20-June 23 - $ 424.15 Session 6 - July 18-21 - $ 424.15
Nadine Baki
4/5/2013
Claire Baki
clairebaki@gmail.com
+19253268910
320 Liveoak Ct Martinez, CA 94553 US
Claire Baki
(925) 326-8910
Luke Baki
9/17/2015
Third Grade
No
No thanks.
Emma Toney
2/17/2017
Sara Toney
saratoney@gmail.com
+19257884600
4581 Alhambra Way Martinez, CA 94553 US
Sara Toney
(925) 788-4600
Kindergarten
No
I am unable right now but please send me more information.
Session 4 - June 27-June 30 - $ 424.15 Session 6 - July 18-21 - $ 424.15
Rory Bass
8/3/2014
Lynn Bass
lynnjhbass@gmail.com
+19252851695
701 Shady Glen martinez, CA 94553 US
Judy and Vic Hutchins
(925) 285-7666
Alex Bass
11/15/2015
Second Grade
No
No thanks.
Session 3 - June 20-June 23 - $ 848.30
Makayla Padilla
9/28/2010
Shannon Padilla
spadilla@dvc.edu
+19253006250
747 Wyoming St Martinez, CA 94553 US
Shannon Padilla
(925) 300-6250
Fifth Grade
No
No thanks.
Session 1 - June 6-June 9 - $ 424.15
Gianna Greene
6/23/2011
Angela Lacativo Greene
alacativo@gmail.com
+19253483513
515 Mellus St Martinez, CA 94553 US
Angela Lacativo Greene
(925) 348-3513
Sierra Greene
6/23/2011
Fifth Grade
Yes
No thanks.
Session 1 - June 6-June 9 - $ 848.30
Tatum Lane
7/27/2015
Tracey Lane
tcbouey@comcast.net
+19255955836
3940 Raap Ave Martinez , CA 94553 US
Tracey Lane
(925) 595-5836
First Grade
No
No thanks.
Session 2 - June 13-16 - $ 424.15
Gianna Greene
6/23/2011
Angela Lacativo Greene
alacativo@gmail.com
+19253483513
515 Mellus St Martinez, CA 94553 US
Angela Lacativo Greene
(925) 348-3513
Sierra Greene
6/23/2011
Fifth Grade
Yes
No thanks.
Session 1 - June 6-June 9 - $ 848.30
Rory Bass
8/3/2014
Lynn Bass
lynnjhbass@gmaill.com
+19252851695
701 Shady Glen Martinez, CA 94553 US
Alex Bass
11/15/2016
Second Grade
No
No thanks.
Session 3 - June 20-June 23 - $ 848.30
Savannah Bacon
5/18/2015
Melodie Bacon
melodie.lane@gmail.com
+19256990256
1048 West Arlington Way Martinez, CA 94553 US
Melodie Bacon
(925) 699-0256
First Grade
No
No thanks.
Radley Sanders
8/16/2016
Monica Sanders
monicalpga@gmail.com
+19253951910
103 Gilrix Drive Martinez, CA 94553 US
Monica Sanders
(925) 395-1910
Kindergarten
No
No thanks.
*Bonus Session - May 31 - June 3 - $ 424.15 Session 1 - June 6-June 9 - $ 424.15
Rhodes Baker
4/28/2013
Toni Baker
terroso@sbclgobal.net
+15102131417
433 Alamatos Drive Danville, CA 94526 US
Toni Baker
(510) 213-1417
Charlie Baker
6/21/2015
Second Grade
No
No thanks.
Session 7 - July 25-July 28 - $ 848.30 Session 8 - August 1 - August 4 - $ 848.30
Amelia Leone
3/29/2013
Amy-Jo Leone
chickpeace@gmail.com
+19252127216
35 Johns Ct Pleasant Hill, CA 94523 US
AJ (Amy-Jo) Leone
(925) 212-7216
Sariah Leone
8/14/2015
Third Grade
No
No thanks.
Session 8 - August 1 - August 4 - $ 848.30
Cameron Ewell
4/14/2013
Timothy Ewell
ewell_tim@yahoo.com
+15108257554
318 Liveoak Ct Martinez, CA 94553 US
Tim Ewell
(510) 825-7554
Third Grade
No
Yes, I'd love to.
Chase Holt
1/13/2012
Madeleine Holt
maddie_is@yahoo.com
+14157939605
PO Box 23422 Pleasant Hill, CA 94523 US
Madeleine Holt
(415) 793-9605
Fourth Grade
Yes
No thanks.
Session 3 - June 20-June 23 - $ 424.15
Lila Williams
6/6/2014
Jennifer Stout
jstout@calalum.org
+14152448920
317 Vista Way Martinez, CA 94553 US
Jennifer Stout
(415) 244-8920
Second Grade
No
No thanks.
Session 2 - June 13-16 - $ 424.15
Perri Hutchins
6/19/2012
marni hutchins
marnidyer@hotmail.com
+19252607043
232 NETHERBY PL Pleasant Hill, CA 94523 US
David Hutchins
(925) 286-4684
Marlowe Hutchins
6/2/2015
Fourth Grade
No
No thanks.
Session 3 - June 20-June 23 - $ 848.30
Emmilyn Lauricella
6/2/2015
Madeline Bell
madeline.bell@hotmail.com
+16318800433
412 saddlebrook lane Pleasant hill, CA 94523 US
David Lauricella
(831) 869-8318
First Grade
No
No thanks.
Session 3 - June 20-June 23 - $ 424.15
Mark Blackshere
4/1/2012
Angel Blackshere
hello@angelspetals.biz
+19259518046
4030 Raap Ave Martinez, CA 94553 US
Angel Blackshere
(925) 951-8046
Mila Blackshere
10/21/2014
Fourth Grade
No
I am unable right now but please send me more information.
Session 2 - June 13-16 - $ 848.30
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