When: Monday-Friday, June 11-15, 2018

Time: 9:00am - 11:40am

Where: Faith Church of Christ (St Rd 29, South Edge of Burlington)

Who: Children ages 4 years to completed 6th grade

*** For security purposes, each child will have a wristband with a 4 digit security code. This code will be the last 4 digits of your phone number. Whoever picks up your child must know the 4 digit code. ***

Child's Name *
Child's Name
Age/Grade Completed *
Address *
Address
Phone Number *
Phone Number
If any, please include:
Emergency Contact # *
Emergency Contact #
Someone your child would like to be with (same age).

Any questions, call Tammy Scott at 765-863-1796.