Camper Name *

Camper Name

First Name

Last Name

Camper 2 Name

First Name

Last Name

how many days are you coming to camp *

1 Day

2 Days

3 Days

4 Days

5 Days

what days are you coming to camp *

Allergies *

Card Name *

Card Name

First Name

Last Name

Card Number *

Exp Date *

Billing Zip *

Security Code *

I Authorize ATAM to Charge My Card.

I have read and I Understand ATAM's Payment and Cancellation Policy. The student will respect the equipment provided at ATAM. If not, Than I Understand that theres is a "you break it, you Buy it Policy".

Signature *

Signature

By typing your name bellow, you are signing your digital signature

First Name

Last Name

Date *

Date

YYYY

Email *

Phone *

Phone

(###)

###

####

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