NINJA LOGIC
2018 SUMMER CAMP SIGN-UP FORM
WEEK 1:

JUNE 25 - 29
JUNE 25 - 29

SESSION A - Age 6-12
SESSION B - Age 13-17

9AM - 12PM
1PM - 4PM

WEEK 2:

JULY 23 - 27
JULY 23 - 27

SESSION A - Age 6-12
SESSION B - Age 13-17

9AM - 12PM
1PM - 4PM

COST:

$125 PER SESSION BEFORE 6/16/2018
$150 PER SESSION AFTER 6/16/2018

Ninja Contact Information:
First Name:
Age:
Address:
Email
Cell Phone:

Last Name:

Home Phone:

Parent/Guardian Contact Information:
Name:
Cell Phone #
Work Phone #
E-mail
Address

Ninja Health Information:
Do you have any health issues: YES / NO
If yes, please explain

** Make Payment to Ninja Logic, LLC
***Mail Payment, Registration Form and Waiver to:
Ninja Logic, LLC
511 West Hanover Street
Hanover, PA 17331

Name:
Cell Phone #
Work Phone #
E-mail
Address