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Summer Camp Registration

July 27th through the 31st, 9 am - 12:30 pm

If there is enough interest we will also add an afternoon session. Open to students who will be in 4th-6th grade in the 2015-2016 school year. Cost is $125 per camper and there are discounts for siblings. If there are donors interested in sending a child to summer camp, there may be scholarships available.

Camper's Name* 
Camper's Nickname 

T-Shirt size      

Birthday       

Please provide phone numbers we can reach you at in case of an emergency during camp.
Home Phone  -  - 
Work Phone  -  - 
Cell Phone  -  - 
E-mail *

If someone other than yourself will be picking up from camp please provide their name and phone numbers below:

Name Home/Work Phone Cell Phone

If you child or children have any allergies or special needs (medical, behavioral, physical, restrictions, medications, etc.) please list them here.

How did you hear about Life is Better Rescue's summer camp?

* denotes required field