2010 Junior Summer Camp Registration 
Form


Please print and complete this form and send with payment to Carl Neufeld at the address
below. 


Name                                                               Age                                                   Gender
Address
City State                                                     Zip
Parent/Guardian's Name  Parent/Guardian's Email
Daytime Phone  Evening Phone 


PLEASE CHECK SESSION ATTENDING: PLEASE CHECK TIME ATTENDING: 

____ Session 1: May 31st - June 4th ____AM+Lunch: 8:30 am-1:30 pm :: $250 
____ Session 2: June 7th - June 11th ____ALL DAY :: $350 
____ Session 3: June 14th - June 18th ____PM Only: 1:30-4:30 p.m. :: $225 
____ Session 4: June 21st -June 25th 
____ Session 5: August 16th - August 20th 

**If you register by April 15th, take $25 off per week per child for half day 
participation and $50 off per week per child for full day participants.** 

Payment Total 

MAKE CHECKS PAYABLE TO: Send Form and Check to: 

Carl Neufeld Carl Neufeld 
PO Box 750216 
Dallas, TX 75275-0216