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Brookfield School Summer Enrollment
2016 Online Enrollment
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Student Information
Student Name *
Date of Birth *
MM
/
DD
/
YYYY
Age (at the time of camp) *
Primary Contact Information
Name of Parent/ Guardian/ Primary Contact *
Mailing Address *
City *
State *
Zip Code *
Home Phone
Cell Phone *
Work Phone
Email Address *
Best way to contact you? *
Please send my paperwork via
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Attendance and Class Choices
Weeks of Attendance *
Required
Days/Times you wish to attend *
Class Choices
Please select your top 3 class choices
Fees/Discounts
$50.00 Registration Fee *
Required
Multiple Students/ Multiple Weeks
Families of once student who enroll in 4 weeks or more of summer or families who enroll two or more students will receive a 5% summer discounts. Families are eligible for only one discount.
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