Child's Name* First Last Child's Email (if they have one!) Primary Contact InformationName* First Last Phone*Email* Secondary Contact InformationName First Last PhoneEmail Any known allergies?* Yes No Please explain allergies including if epipen is neededAny other health issues?* Yes No If other health issues, please detail here.Anything else we need to know?Camp InfoSummer Camp Price: $0.00 Sign me up for ...* A week of coding camp - $400 Lunch! And snacks! - $50 An extra hour or two after - $50 Payment Options* Pay Full Amount Deposit - half now; half in June Total $0.00 Payment Method* Credit Card via PayPal Check Checks made out to Elizabeth Mettler at 2908 Brandywine St NW, Washington DC 20008
