| Name | Date of Birth | Name | 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) | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Wyatt Klopp-Niemi | 11/17/2014 | John Klopp | klopp@pacbell.net | +14158612171 | 1300 Merrithew Dr
Martinez, CA
94553
US | John Klopp | (415) 861-2171 | First Grade | No | No thanks. | *Bonus Session - May 31 - June 3 - $ 424.15
Session 1 - June 6-June 9 - $ 424.15
Session 3 - June 20-June 23 - $ 424.15
Session 4 - June 27-June 30 - $ 424.15
Session 5 - July 11-July 14 - $ 424.15
Session 6 - July 18-21 - $ 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 |
