Moab Valley Multicultural Center

Thank you for your interest in registering for the Splashin' Spanish Summer Camp with the Moab Valley Multicultural Center!

Camper Info

Camper Name*

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Gender*

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Date of Birth*

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Grade*

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Parent/Guardian Info

Your Name*

Please let us know your name.

Address*

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City*

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State*

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Zip Code*

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Your Email*

Please let us know your email address.

Phone Number*

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Does your child have allergies? *

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Emergency Contacts

Emergency Contact Name*

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Emergency Contact Phone*

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Relationship to Student*

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Emergency Contact Name*

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Emergency Contact Phone*

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Relationship to Student*

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Additional individual(s) authorized to pick up my child

Name 1

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Phone 1

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Relationship to Child

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Name 2*

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Phone 2*

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Relationship to Child*

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Session Selection

Please check the sessions for which your camper would like to attend. Splashin' Spanish Summer Camp tuition is $60 per child per week. Tuition assistance is available. If sending your child to this camp will create a financial hardship for your family, you are encouraged to fill out the tuition assistance application. To ensure participation in the following sessions, full payment is due with registration. Payment is refundable if you cancel 1 week prior to the camp start date.

Week 1 – July 22-25 - 60.00 USD

Week 2 – July 29- August 1st - 60.00 USD

Both weeks - 120.00 USD

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Thank you for submitting your registration to Moab Valley Multicultural Center!

Total

0.00 USD