Park Shore Day Camp - country day camp and school

Request For:

Full Day Camp Program
Super Senior Program
Explorer Travel Program
SuperTeen Travel Program
Nursery School Program
Sports Track Program
Performing Arts Track Program
My Tot & Me Program

Parents Information

First Name:
Last Name:
Address:
City:
State:
Zip:
Home Phone #:
Work Phone #:
Email Address:

Child(ren) Information

Child's Name:
Birthdate:
Grade Completed as of June 2008:
Child's Name:
Birthdate:
Grade Completed as of June 2008:
Child's Name:
Birthdate:
Grade Completed as of June 2008:

Additional Comments and/or Information: