Reserve Your Camp Spot CHILD INFORMATION Name * First Name Last Name Age * Grade Entering Fall 2023 * Camp/Workshop to Attend * Holistic Executive Functions Summer Camp Creative Writing & Executive Functions Workshop College Essay Writing Workshop Camp Dates Interestetd June 19 - June 23 June 26 - June 30 August 14 - August 18 August 21 - August 25 Allergy and/or Health Information * If none, write none. Sibling Names We will apply a $50 discount for each sibling after the first. PARENT INFORMATION Name First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country PAYMENT INFORMATION Name * Credit Card Number * Expiration Date * CVV Code * Thank you for submitting your request for our camps/workshops. We will reach out to you asap to confirm your spots.
