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Register for theWELLstudents summer camp "Mile 20" by filling out the information below

Student's Name

Parent's (Guardian's) Name

Your contact info:

Email Address

Phone Number

Can you recieve text messages?

Yes

No

What is the best way to reach you?

Email

Phone

Please enter your full address:

Street Address

City

State

Zip Code

Registraion Fee: $300.

A check can be made out to theWELLbuffalo or cash turned in with student registration form.

Registration Fee

Paid

Un-Paid

Check What size t-shirt your child will need below:

T-Shirt Size

Small

Medium

Large

X-Large

Any Questions?

Mile 20 Summer Camp August 8-12 2016