Edmond Historical Society

Parent Name*

First Last

Parent Phone*

Parent Email*

Emergency contact person (other than parent listed above)*

First Last

Emergency contact phone number*

Child(ren) you are registering*

To add additional children, click the plus sign to add another row.

Child Name	Birthday (Month/Year)	Gender	Has this child attended our summer camp before?	Any allergies?

Camp Registration*

Enter the number of children you are registering in the "Quantity" box.

Price: $50.00 Quantity:

Total

$0.00

Be sure you are registering for the session you want--this form is for Session 4, which is June 28, 29 & 30.

Payment method*

Please select whether you'd like to pay securely online, or mail a check.

Pay online by credit card
Mail a check

When you click "submit," you'll be redirected to the secure payment form. Fill out this form with your credit card information to make your payment online!