Applicant Information
First Name:
Middle Name:
Last Name:
Nickname:
Address Street:
City:
Zip Code:
State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Birth Date
Age at Camp:
Gender: Male Female
Grade in Fall:
Gymnastics Club or Program:
Club/Program Type: Recreational Competitive
Club/Program Level:
Contact Information
Daytime Phone:
Evening Phone:
Cell Phone:
Email:
Sessions
Cost:
$595/week $1050/2 weeks
Camp Activity: Select One Gymnastics Cheerleading
Camp Week: Select One Week 1: Aug. 16th - 22nd Week 2: Aug. 22nd - 28th Weeks 1 & 2: Aug. 16th - 28th
Bus Information
Cost:
$50 Each way (if needed)
Bus Usage: Not Needed One Way Round Trip
Bus Pick Up Site: None Gurnee, IL Brown Deer, WI Madison, WI Waukesha, WI
Bus Drop Off Site: None Gurnee, IL Brown Deer, WI Madison, WI Waukesha, WI
Payment Information
Tuition: $595 $1050 $395 (commuter)
Bus: $0 $50 $100
Family Discount: None Second Child - 5% 3rd(+) Child - 20%
Credit:
Credit Description:
Payment Type: Select One Check Credit Card
Amount Paying:
Credit Card Information (if chosen)
Credit Card Type: None Selected VISA Master Card
Card Number:
Expiration
Name on Card:
Other Information