SUMMER CAMP & INTENSIVE REGISTRATION FORM Please fill out the registration form below. Questions? We can be reached by telephone at 716.204.8192 or email. Summer Camp & Intensive Registration Form Student Name* First Last DOB* Date Format: MM slash DD slash YYYY Age*Parent(s) Name*Does your child have any allergies?*Address* Street Address City ZIP / Postal Code Phone (Cell)*Phone (Home)Phone (Work)Email(s)* Student School (if applicable)Requested Camps or Intensives*Referred by:Fees* Summer Camp/Intensive Deposit - $50 NameThis field is for validation purposes and should be left unchanged.