Online Spring Camp Registration 2019 – Hart to Hart Farm and Educational Center

Camper's Name

First Last

Gender

Date of Birth

Grade in the Fall

T-Shirt Size

Parent(s) / Guardian(s) information & BILLING INFORMATION)

Name of Parent(s) / Guardian(s)

First Last

This field is also used as billing information

Email of Parent(s) / Guardian(s)

Address of Parent(s) / Guardian(s)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

This field is also used as billing information

Relationship to Camper

Phone (Primary)

Phone (Secondary)

Email

Product Name

2019 Spring Farm Day Camp - $275 per Session - Deposit of $50.00

Additional Comments / Inquiry?

Credit Card Service Charge

$1.75

Total (50% Deposit)

$0.00