Lifestone Kids Camp 2024

Participant

Student Name

Grade (4th, 5th or 6th entering 2024-25 School Year)

Guardian

Parent Name

Parent Phone

Parent Email

This address will receive a confirmation email

Payment

Non-refundable $25 deposit is due at time of registration. You may return to this form at a later date to make payments toward your total of $130 per participant.

Deposit & Payments

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

June 28-29

Please fill out this form and click submit.

Lifestone Kids Camp 2024

Description

Please Fix the Following