Each 5-day (3-hr per day) camp is $200 and includes all materials, equipment and a daily healthy snack.

Please indicate your first and second choice of the camp you wish to attend.  Camps are filled on a first-come first served basis.

FIRST CHOICE (date) _____________   

SECOND CHOICE  (date) _______________

STUDENT NAME __________________________________

STUDENT AGE _________  Female ____ Male _____

PARENT NAME ____________________________________

ADDRESS __________________________________________

PHONE ____________________________________________

E-MAIL ____________________________________________
 

TOTAL ENCLOSED:  __________________
(# of 1-week camps desired x $200)

Please make checks payable to: Demetra McMullan
Mail to:  21333 Thimbleweed Court, Ashburn  VA  20147

Client assumes all risks involved.  Client hereby acknowledges that he/she proceeds at their own risk, and indemnifies and holds harmless Demetra McMullan, for any injury, act, or liability that occurs to the client or his/her family as a result of the use of the services and premises provided.

Full refunds are available and must be requested (at least one week) before the first day of the registered camp.  Refunds are not available after the first day of a camp for any reason. 

I understand and agree to the above conditions.

Name____________________________Date_____________