campregistration

SACSPA Summer Camps 2011

Registration Form

Class fee: $125.00 per week

Parent Name(s):

Email address:

Home Phone:

Work Phone:

Cell Phone:

Student Name:

Select camps:

Emergency Contact:

Name:

Phone:

Relationship:

Medical Information:

Does your child have any allergies? Medications?

If yes, please explain:

Doctor's name:

Phone:

Please describe any physical problems or limitations your child has (if any):

Please select your payment method:

To pay by PayPal, please use the button:

To pay by check or money order, please make payable to SACSPA and mail to:

St. Augustine Community School of Performing Arts

214 San marco Avenue

St. Augustine, FL 32084