Crossroads Kids Camp 2023 June 19-23, 6-8 pm

Child 1 Name

Child 1 Birthdate

Grade completed

Child 2 Name

Child 2 Birthdate

Grade Completed

Any more children. Please give names, birthdates and grade completed for each child.

This address will receive a confirmation email

Phone

Address

Payment-only children from the same household may be paid for together.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

June 19-23, 6-8 pm

Please fill out this form and click submit.