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2017 Summer Camp - Tampa Palms

This form will be submitted to the following clubs:
East Lake Woodlands Country Club
Child's Information
Child's First Name:
Child's Last Name:
Address:
City:
State:
Zip Code:
How should we contact you ?
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Additional Information
Paren'ts Name
Address
City
State
Zip
Camp Sessions
(Check all that apply)
 Session 1: May 29th - June 2nd
 Session 2: June 5th - June 9th
 Session 3: June 12th - June 16th
 Session 4: June 19th - June 23rd
 Session 5: June 26th - June 30th
 Session 6: July 3rd - July 7th
 Session 7: July 10 - July 14th
 Session 8: July 17 - July 21st
 Session 9: July 24th - July 28t
 Session 9: July 24th - July 28th
 Session 10: July 31st - August 4th
 Session 11: August 7th - August 11th
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Home Phone
Work Phone
Cell Phone
Email
Child's Age
Child's Date of Birth
Club Member
(select all that apply)
 Yes
 No
Member # (if applicable)
You will receive an e-mail confirmation from the Club within 3 days of enrollment.

  

* Bold Fields are Required