Summer Camp 2023 Registration
Disney's 101 Dalmations

Registration Form

Student's First Name

Student's Last Name

Student's Cell

Student's Email

Parent's Email

Street Address

State

Zip code

City

Age (as of 6/26/23)

Parent/Guardian 1 Name

Parent/Guardian 2 Name

Emergency Contact

Parent/Guardian 1 Phone

Parent/Guardian 2 Phone

Emergency contact phone

Allergies/Health related issues, including any diagnoses which might affect behavior. If none type "N/A"

Is there any additional info that you would like us to know?

I agree to the Release of Liability and Permission to Secure Treatment

I agree to the Participant Agreement and Discipline Guidelines

I agree to the Photo Release

I acknowledge that T-shirts are not guaranteed if registered after June 1st, 2023. No refunds are offered after June 6th, 2023.

I give my child permission to participate in AIM's production. (Sign here)

Select a payment item:

Non-Member Summer Camp Fee - $200.00

Non-Member Sibling Summber Camp Fee - $175.00

Current Member Summer Camp Fee - $175.00

Current Member Sibling Summer Camp Fee - $150.00

We have received your registration!