Winter Break Camp

Student Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Phone *

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Form of Payment *

Payment due in full within 24 hours of sign up.

Email Invoice

I’ll pay cash

Venmo (@ottumwa2320)

I understand that I must sign a release of liability for my student before the first class. *

You will be taken to the link to sign online after submitting this form.

Yes