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Camp Week

Select One Or More Camp Weeks:

Camper Information

Name: Nathaly Pina Gonzalez

Age: 11

Grade Going Into: 6

School Name: St. Elizabeth Seton Catholic

Address: 14980 Schooner bay lane
Apt 18202
Naples, Fl 34119

Parent/Guardian Information

Name: Nathaly Pina Gonzalez

Primary Phone: 2396829288

Secondary Phone:

Email: thaly7@me.com

Relationship To Child: Mother

Does Your Child Need a Modification / Accommodation?

Electronic Signature: I agree to send my child to Ocean Kids Camp

Name Of Person(s) Allowed To Pick Up Child

Name Of Person(s) NOT Allowed To Pick Up Child

Payment

Total Cost ($200/Week): 0.00

Scholarship#: 100