Visions of Windsor Summer Camp Registration Form

Child’s name:                                                                                                                                    

Name of Parent/Guardian:                                                                                                              

Address:                                                                                                                                             

City:                                                                                          State:               Zip:                         

Home phone:                                                   Work phone:                                                           

Cell phone:                                                       Household email:                                                   

Child’s Birthday:                                 Age:                 Child’s School:                                           

Grade or equivalent in fall 2008:                   Sex (check one): □ Male   □ Female

T-shirt size:                    

A $25 non-refundable deposit is due to register for the program. The balance is due by August 1, 2008. 

Total enclosed: $ _______________________________________________________________

Make checks payable to the Windsor Historical Society.

Credit card number: ____________________________________________________________

Expiration date: ________________________________________________________________

Signature: _____________________________________________________________________

Please send registration and payment to:

Windsor Historical Society, 96 Palisado Avenue, Windsor CT 06095