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Spring Break 2008 Camp Registration Form |
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Fill Circle(s) Below |
Camp |
Dates | Ages | Price |
Notes: |
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OO OO OO OO OO |
Ready, Set, Spring! Spring Into the Real Thing Spring is in the Stars Nuts, Bolts and Springs Spring to Mind-It's all about Me! |
3/31/08 4/01/08 4/02/08 4/03/08 4/04/08 |
5 - 11 5 - 11 5 - 11 5 - 11 5 - 11 |
$30.00 $30.00 $30.00 $30.00 $30.00 |
All camps are 9:00am to 4:00 pm.
Lunch not provided, but two snacks are, per day.
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_____________________________ _________________ Name Birthdate (child #1) _____________________________ __________________ Name Birthdate (child #2) ________________________________________ Name (parent/guardian) ________________________________________ Mailing Address ________________________________________ City, State, Zip ________________________________________ Phone ________________________________________ |
Subtotal: ________
Members, -10%:________
Member #: ________
Total: ________ |
Contact Jim Hodgin at 260-424-2400 ext 451 for more information.
Faxes: 260-422-2899 |
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Early drop off and late pickup are available at $3.00/half hour. Please call Jim for more information. | ||||
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O Check
O Visa
O MasterCard
O Discover |
Name on Card: _____________________________________
Billing Address for Card: _____________________________
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Credit Card #: ______________________Exp: Date:_______
Signature:_________________________ 3-digit code: ______ |
Send to:
Science Central 1950 N. Clinton Fort Wayne, IN 46805 www.sciencecentral.org |
**Register before 2/15/08 to receive $10 off total registration cost for campers attending all five days.