2009 Summer-Camp Programs

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Registration Information

   Required fields are in bold. Fill in "N/A" if the field is not applicable.

PROGRAM INFORMATION
Chinese		Tennis
Visual Art (drawing)		Visual Art (painting)
Kung Fu		Dance
Tae Kwon Do		PingPong
STUDENT PERSONAL INFORMATION
First Name:		Middle Name:
Last Name:		Chinese name:
Date Of Birth:
Gender:	Female Male
ACADEMIC INFORMATION
School Name:	--Select School Name-- Orange - Cameron Park Orange - Carrboro Orange - Central Orange - Efland Cheeks Orange - Ephesus Orange - Estes Hills Orange - FP Graham Orange - Glenwood Orange - Grady Brown Orange - Hillsborough Orange - Mary Scroggs Orange - McDougle Orange - Mel and Zora Rashkis Orange - New Hope Orange - Pathways Orange - Seawell Orange - A L Stanback Orange - Grey Culbreth Orange - Guy Phillips Orange - McDougle Orange - Smith Orange - Stanford Orange - Gravelly Hill Durham - Bethesda Durham - Burton Durham - Club Blvd Durham - Creekside Durham - E.K. Powe Durham - Easley Durham - Eastway Durham - Eno Valley Durham - Fayetteville Durham - Forest View Durham - George Watts Durham - Glenn Durham - Harris Durham - Hope Valley Durham - Lakewood Durham - Little River Durham - Mangum Durham - Merrick-Moore Durham - Morehead Durham - Oakgrove Durham - Parkwood Durham - Pearson Durham - Pearsontown Durham - Southwest Durham - Spaulding Durham - Y E Smith Durham -Hillandale Durham -Holt Durham - Brogden Durham - Carrington Durham - Chewning Durham - Durham School of the Arts Durham - Githens Durham - Lowes Grove Durham - Neal Durham - Rogers-Herr Durham - Shepard
Grade Level:	--Select Grade-- Kindergarten 1st grade 2nd grade 3rd grade 4th grade 5th grade 6th grade
Primary Language:
Secondary Language:
Mandarin Proficiency:	--Select Mandarin Level-- Beginner Moderate Fluent
CONTACT INFORMATION
Father's Name:
Mother's Name:
Primary Phone:
Secondary Phone:
Cell Phone:
Email:
Mailing Address:
Emergency Contact:
Emergency Phone:
MEDICAL INSURANCE INFORMATION
Insurance Provider:
Insurance ID:
Insurance Phone:
OTHER
Special Care:
Additional Notes:
By select this you AGREE to our Tuition and Emergency Policies.