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Print and Fill Out and Return to |
| BRANDON
DIVING CAMP 405 Beverly Blvd. Brandon, FL 33511 |
| Name | Male___ | Female___ | Age____ | |
| Address | State | Zip | ||
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| Telephone home | ||||
| Telephone work | Cell phone |
Sessions |
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June |
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June 10-17 |
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June 17-24 |
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June 24-July 1 |
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July |
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July 1-8 |
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July 15-22 |
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July 22-29 |
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With housing |
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Without housing |
| Enclose Deposit of $100 to hold space. | $_______ | balance due before 1st week of camp |
| I wish to pay Total now. | $_______ | |
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Signature Parent or Guardian______________________ |
Print Name _________________ |
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Fill Out and return to |
Any Questions or Comments |
| BRANDON
DIVING CAMP 405 Beverly Blvd. Brandon, FL 33511 |
(813)
689-0908 phone (813) 681-3028 fax |
| e-mailjetdive@aol.com | |
| web: www.brandonswimandtennis.org |