Summer Camp Enrollment Form

Student Name_______________________________________________

Parent / Guardian____________________________________________

Address____________________________________________________

Phone_______________Work_______________Cell _______________

Age___Birth date____________Grade___ School__________________

Medications/Health Issues__________________________________________________________________________________

Registration for camp requires a $35 deposit

Please makes check payable to: Ki Center

Send to:

Ki Center

1137 N. Tucson Blvd.

Tucson, AZ 85716