Camp4Real Kids Night Out at

Crozet Elementary on February 8th!

Details:

Who: Any child from any school ages 5-12

Cost: $20 per child, $30 two siblings, $40 three siblings, $50 four siblings (Early Bird Pricing)

Time: 5:30 to 8:30pm

*scholarships available

Check out Camp4Real at Stone Robinson, Cale, and other locations throughout Albemarle County at Camp4Real.com!

How Many Children?

1 Child ($30.00)
2 Children ($40.00)
3 Children ($50.00)
4 Children ($60.00)

Please list any allergies/accomodations for any of above children

Parent/Guardian who will pick up/drop off child(ren)

Name

Phone Number (night of event)

Emergency Contact

Name

Phone Number (night of event):

Terms

Yes -- I accept and assume such risks and responsibility and hereby release, discharge, and covenant not to sue Camp4Real, LLC in the event of losses and/or damages following any such injury disability, paralysis or death, however caused and whether caused in whole or in part by negligence of the Camp4Real staff.

I have read and agree to the terms above.

Total

$0.00

Billing Information

Name

Card Number

Visa
Mastercard
Discover

Expiration Date

Country

Address

City, State and ZIP Code

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