EmailMe Form - Pizzeria Camp Form

Camper's Name *

First Last

Camper's Age *

Gender

Birthday

Parent/Guardian Name(s)

Phone

### - ### - ####

Address

Street Address City State / Province / Region Postal / Zip Code Country / Region

Email *

Special Notes About Camper

Select Regular Day (9:30am-1:30pm) or
Extended Day (9:00am-3:00pm) *

Second Camper

If you would like to register a second camper please fill out the following section, if you have more than 2 children to register please fill out a new form.

Second Camper's Name

First Last

Second Camper's Age

Second Camper's Gender

Second Camper's Birthday

Select Regular Day (9:30am-1:30pm) or
Extended Day (9:00am-3:00pm) *

Payment:
Regular Day Cost is $40/1st Child and $25/Sibling.
Extended Day Cost is $60/1st Child and $35/Sibling.

Payment is required upon reservation. This is non-refundable, but transferrable to other camps if needed.

Card Type

Name on Card

Card Number

Expiration Date

Billing Zip Code

Paypal

Yes, I'd rather use PayPal

Check here if you'd rather be billed through PayPal (will be sent through email)

Second Camper

Payment: Regular Day Cost is $40/1st Child and $25/Sibling. Extended Day Cost is $60/1st Child and $35/Sibling.

Payment:
Regular Day Cost is $40/1st Child and $25/Sibling.
Extended Day Cost is $60/1st Child and $35/Sibling.