Ziemer.com | Online Registration Form

Online SCA Winter Academy, Petaluma

CLICK HERE FOR OTHER CAMPS REGISTRATION FORM

Camper/Parent Information

Please type

in this field to continue:

(all UPPER case)

Check Appropriate button

Amount Sessions
1 day per week $85, Tuesday only, 3:45pm - 5:15pm, January 5 - February 24
1 day per week $85, Friday only, 3:45pm - 5:15pm, January 8 - February 26
2 days per week, $145.00 Tuesday and Friday, 3:45pm - 5:15pm, January 5 - February 26

T-shirts size:

Camper Name:

Street

City:

State:

Zip

Parent Name:

Phone: (Daytime):

Phone (Evening):

Emergency Phone:

Date of Birth:

Gender:

Email Address:

Payment Information:

Comments:

Credit Card Payment - Due to security purposes, we will call you for your credit card information.

Check Payment - Please Mail Check to:
SCA - Winter Camps
P.O. Box 905
Petaluma, CA 94953
Make checks payable to SCA

Check Number:


Some contents may require the free Adobe Acrobat Reader or Flash Player