JUNIOR FARMERS  SUMMER VACATION REGISTRATION 

WE HAVE BEEN HAVING SOME HOSTING PROBLEMS-IF YOU CANNOT SUBMIT THIS FORM-PLEASE FILL IT OUT, PRINT IT DOWN AND MAIL IT TO THE FARM. THANK YOU

CONTACT INFORMATION

CHILD'S NAME:
 PHONE:
 EMAIL:
  
ADDRESS:
 CITY:
 STATE:
 ZIP:

PROGRAM INFORMATION: First time participants must be 4 1/2 yrs old by July 1st and self sufficient with facilities -participants are separated by age into groups- enrollment ages are 4 1/2 to 12

PROGRAM TYPE:(7/28 &7/7 full)

EXTENDED AFTERNOON SESS.12:30-4:00

  

 
SESSION-all sessions are considered available unless noted otherwise-please do not call for availability  
 AGE OF CHILD/COMMENTS must be 4 1/2 by July 1st to register thru 12yrs old:  

 PAYMENT INFORMATION-please read carefully: As of June 1st tuition must be paid in full
  Final payments can be made by check but must be received on or before MAY 30th. If final payment is not received by may 30th, balances will be charged to your credit card on file  JUNE 1st. DEPOSITS AND TUITION PAYMENTS ARE NON-REFUNDABLE.

I HAVE READ AND ACCEPT PAYMENT POLICIES:tuition must be paid in full after June 1st  

 

NAME ON CARD:
PAYMENT TYPE:  
CREDIT CARD NUMBER (PLEASE ADD DASHES BETWEEN GROUPS OF NUMBERS):
EXPIRATION DATE:
BILLING ADDRESS:  
SECURITY CODE (back of card):