Summer swim camp Payment FORM

Camp Week

• Wk 1: June 27th
• Wk 2: July 4th
• Wk 3: July 11th
• Wk 4: July 25th
• Wk 5: August 8th
• Wk 6: August 15th

Number of Enrolled Children. *1 Child2 Siblings3 Siblings4 Siblings5 Siblings

Child 1 *

First

Last

Child 2 *

First

Last

Child 3 *

First

Last

Child 4 *

First

Last

Child 5 *

First

Last

Phone *

Email *

Payment Options *

• 1 x Child - € 37.50
• 2 x Siblings - € 72.00
• 3 x Siblings - € 104.00
• 4 x Siblings - € 131.00

Notes/Comments/Feedback/Queries

Total

€ 0.00

Card Details *

Card

Name on Card

Complete