SASS Day Camp Registration

• Parent Information
  • Your Name*
    First Name

    Last Name
  • Your E-mail*
     
  • Your Phone Number*
     

    (###)

    -

    ###

    -

    ####
• Participant Information
  • Child Name*
    First Name

    Last Name
  • Date of Birth*
    MM

    DD

    YYYY
  • Family Doctor Name
  • Family Doctor Phone Number
     

    (###)

    -

    ###

    -

    ####
• Emergency Contacts

  Please note that children will only be released to either the parent or an emergency contact at pick-up. If you need to give authorization for additional pick-up individuals, you can do so in the comment box below or by contacting Sofia (sofiacavelino@gmail.com) at any time.
  • Emergency Contact #1*
    First Name

    Last Name
  • Emergency Contact #1 Relation to participant*
  • Emergency Contact #1 Phone Number*
     

    (###)

    -

    ###

    -

    ####
  • Emergency Contact #2
    First Name

    Last Name
  • Emergency Contact #2 Relation to participant
  • Emergency Contact #2 Phone Number
     

    (###)

    -

    ###

    -

    ####
  • Allergies, dietary restrictions, medical concerns, or any comments:
• Payment

  Once you press submit below, you will be re-directed to a paypal page to pay the $50 registration fee. If you are not redirected or if you have any questions or concerns, please contact Sofia directly at sofiacavelino@gmail.com
• 
  Submit