City of Highland Heights
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Day Camp - 4 Weeks

Part Number 9009-4
Day Camp - 4 Weeks
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Your Price:

Please select the appropriate rate. Information provided, and residency will be verified by the Recreation Dept.

Choose Options
Regular Fees
Resident of Highland Heights [$530.00]
Non-Resident [$670.00]
Weeks your child will attend June 4-June 8
June 11-June 15
June 18-June 22
June 25-June 29
July 2-July 6
July 9-July 13
July 16-July 20
July 23-July 27
Registration Camper's Name:

Camper's Swim Level:

Birth Date:

Grade Fall 2018:

Home Phone:

Emergency #:



Email Address:

Shirt Size (sizes run small)
Guardian 1 Mother/Guardian Name:

Work #:

Cell/Pager #:

Guardian 2 Father/Guardian Name:

Work #:

Cell/Pager #:

Emergency Contact Name:

Phone #:

Cell/Pager #:

Allergies Food Allergies/Dietary Restrictions:

Special Request My child requests to be placed with (1 request only):

Additional Programs - Please select other programs you have registered for. Swim Lessons
Tennis Lessons
Convenience Fee
Convenience Fee [$3.00]
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