I know I Can Summer Camp 2020

First Name

Last Name

Gender

Age

School

Grade attended year 2020

Home Address

City

State

Zip

Country

Telephone

Cell

Parent Email

Mother's Name

Mother's Day Number

Mother's Cell

Father's Name

Father's Day Number

Father's Cell

Specify any of your child's health problems/allergies (including food allergies)

Each participant will be issued a tablet for classroom activities ONLY , I understand that if the tablet is broken or destroyed in any way I will replace the tablet with the fee of $49.99, payable to VALNNCC. I also understand that it must be return undamaged at the end of the virtual summer camp.

By returning this completed electronic form I agree to all terms and conditions.

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I know I Can Summer Camp 2020

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