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Shelter Island Show Kids Registration Form
Camper's Full Name:	* required
Age:	* required
Date of Birth (mm/dd/yyyy):   Age as of July 1st:	* required  * required
Parent/Guardian(s) Full Name:	* required
Email address:	* required
Local Phone: Cell Phone:   Work Phone:   Emergency Number I: Emergency Number II:	* required  * required  * required  * required  * required
Local Mailing Address (PO Box):       Non-Shelter Island Address:	*Required *Required
Request to be registered for:
Show Kids Program:	(Select One) Show Kids Mini Show Kids
Select Method of Payment:     Pay on-line with Credit Card (See Below) ** If you do not wish to pay with a Credit Card, please Print the form and mail it in with your Check deposit. Registration will not be complete without a Deposit. **        * required Special Info for the directors:

Health Form.PDF