2024-2025 Poplar Bluff R-I School Year Camp Day Registration

2024-2025 Camp Day Registration

Child's Name

First Name *

Last Name *

School your child currently attends

Grade your child is currently in

Good Friday - Boys & Girls Club closed to kids on April 18, 2025

April 21, 2025

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April 22, 2025

April 22, 2025 Camp Day is the Color Run at Bacon Park

If your child is attending camp day on April 22, please select YES or NO. If you are not signing up for this camp day, please select UNSURE

I give my permission for my child to go to Bacon Park to attend the Color Run
I do not give my permission for my child to go to Bacon Park to attend the Color Run
I am unsure if my child will be attending the April 22, 2025 Camp Day

Parent/Guardian Name

First Name *

Last Name *

Parent/Guardian Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Parent/Guardian Phone

Parent/Guardian Email

Cardholder Name

Credit Card #

Visa MasterCard American Express Discover

Expiration Date

Security Code

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged