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Sign-Up Form for Community Connections Summer Camp

Name of first child____________________________
Entering Grade______ School___________________
Name of second child__________________________ Entering Grade______ School____________________
Parent/Guardian Name___________________________ Phone(s) ___________________________
Address_____________________________ City/State_____________ Zip_______
Email_____________

Weeks: Circle week(s) and location(s) you want to attend.We will confirm by mail.

Week 1: Waterways Week
Week 2: I Love a Parade Week
Week 3: Good Old Summertime OR Nature Adventure
__swim Berlin __swim Rumney
Week 4: Gooey & Gross OR Dance Dance
__swim Berlin __swim Rumney
Week 5: Walls & Water
Week 6: Gymnastics OR Daring and Dangerous
Week 7: Discover Montpelier OR Nature Adventure
Week 8: Wet & Wild

Do you plan to use extended care? ___ Please specify dates and hours:_________________________

Would you like to volunteer to chaperone?_________________________________________

Please send this sign-up form, a new registration form, and $25 per child to Community Connections, 58 Barre St., Montpelier, Vt. 05602. Please make checks payable to “WCSU” (Washington Central Supervisory Union).