one-week summer course Name of Parent * First Name Last Name Email * Phone (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Name of child * First Name Last Name Age of child * Select your week of participation * July 14-18 August 4-8 August 11-15 Does you child have any allergies or dietary requirements we should know about? Does you child have any disabilities? Is there anything else you would like us to know? Thank you! We will be in touch with you very soon and are looking forward to working together. We won’t send an invoice until we know the summer course is happening 100%.