2024 SMF Summer Camp Registration
Please refer to www.strebekahorlando.org/smf for details about the Summer Camp for each age group.
Participant(s) information
Participant's Name
*
Date of Birth
*
Grade
*
Please select one option.
PK3
VPK
KG
G1
G2
G3
G4
G5
G6
G7
G8
G9
G10
G11
G12
Select Option
PK3
VPK
KG
G1
G2
G3
G4
G5
G6
G7
G8
G9
G10
G11
G12
T-shirt size
*
Please select one option.
YS
YM
YL
S
M
L
XL
XXL
Select Option
YS
YM
YL
S
M
L
XL
XXL
Parents information
Parent's First name
*
Parent's Last name
*
Email
*
This address will receive a confirmation email
Phone
*
Emergency contact information
Emergency contact name
*
Emergency contact phone
*
Emergency contact relationship to the child
*
Payment
Pre-school Payment
No participants ($0)
Participant ($100)
No participants ($0)
Participant ($100)
Amount
Elementary Payment
No participants ($0.00)
Participant ($125)
No participants ($0.00)
Participant ($125)
Amount
Middle school Payment
No participants ($0.00)
1 Participant ($80)
No participants ($0.00)
1 Participant ($80)
Amount
High school Payment
No participants ($0.00)
1 Participant ($80)
No participants ($0.00)
1 Participant ($80)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Please refer to www.strebekahorlando.org/smf for details about the Summer Camp for each age group.
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