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Youth OUT-OF-THE-BOX CGI!

OUT-OF-THE-BOX CGI! - REGISTRATION

Camper Information
Please fill out one form per camper
Name*
First NameLast Name
Jewish Name*
Date of Birth*
MonthDayYear
School Attending*
Grade Entering*
Gender*
MaleFemale
Family Information
If you have already registered another child you may leave this section blank

Family Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent One
First NameLast Name
E-mail
Cell Phone Number
Area CodePhone Number
Parent Two
First NameLast Name
E-mail
Cell Phone Number
Area CodePhone Number
Questions / Comments
Dates
Please enroll my child for:
Full Season: 6/22 - 7/31 - $534.60 (10% Discount)1st Session: 6/22 - 7/10 - $2752nd Session 7/13 - 7/31 - $275Week 1: 6/22 - 6/26 - $99Week 2: 6/29 - 7/3 - $99Week 3: 7/6 - 7/10 - $99Week 4: 7/13 - 7/17 - $99Week 5: 7/20 - 7/24 - $99Week 6: 7/27 - 7/31 - $99
A minimum ~~$99~~ ($89 during flash sale) deposit is due upon registration. Remainder due by Friday, June 19 2020
Total
$0.00

I would like to pay today: Full amount$99.00 minimum $
Yes, I'd like to donate the cost of processing this transaction by adding 3%
Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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