*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

First
Last
Home Address
Home Address
City
State/Province
Zip/Postal

Student Info

Name
Name
First
Last

Days to Attend

Tuesday
Wednesday
Thursday
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$
Credit Card
Credit Card
Credit Card Number
Expiration Month
Expiration Year
CVC