Polar Bear Weekend Sign Up

Parent's Name

Student #1 Name

Student #2 Name

Student #3 Name

This address will receive a confirmation email

Phone

Payment

Notes/Additional Student's Names

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

January 14th and 15th, 2022

Please fill out this form and click submit.
Cost: $85 (1st child), $40 (2nd child), $20 (3rd child)