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JACH Children’s Day Camp
June 19, 20,21 and 22 2017
9am-3pm
C.W. Avery Family YMCA and IRA Jones Middle School (Plainfield PSD202)
Cost $50-included lunch, snacks, and supplies for the 4 days.
(Scholarships are available)
Pre-registration is required.
Name
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First
Last
Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Phone
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List Name & age of each child
Was loved one who died in Hospice care?
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Yes
No
Call if scholarship is required.
Checkbox
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One Child attending
Two Children attending
Three Children attending
Four Children attending