*Note: if a class doesn’t meet minimums, they will be canceled and you will be refunded the full amount. 2022 Christmas Break Mini Camp Parent/Guardian Contact Info Name * First Last * Last Relation to Child * Email * Phone * Home Address Home Address Home Address Home Address City City State/Province State/Province Zip/Postal Zip/Postal Student Info Name * Name First First Last Last Birthdate * Please list any allergies the student has. Days to Attend Tuesday 12/20/2022 Wednesday 12/21/2022 Thursday 12/22/2022 Add Remove Total $ Credit Card * Credit Card Credit Card Number Credit Card Number Expiration Month Month 123456789101112 Expiration Month Expiration Year Year 20232024202520262027202820292030203120322033 Expiration Year CVC CVC If you are human, leave this field blank. Submit