Camper's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Parent/Guardian #1: Name *

First Name

Last Name

Parent/Guardian #1: Phone Number *

(###)

###

####

If you would like to register for Camp Wonder, please select your top 3 preferred weeks. Due to high demand, Opal will only be offering one week of camp to each applicant. If space allows, campers may be offered a second week. This will be determined on a first come, first served basis.

Week 1: Ages 5-11 (June 30th - July 4th) FULL

Week 2: Ages 18+ (July 7th - 11th) FULL

Week 3: July 14-18 (Ages 12-19) FULL

Week 4: Ages 10-14 (July 21st - 25th) FULL

Week 5: July 28 - August 1 (Ages 12+) FULL

Week 6: August 4-8 (Ages 3-7) FULL

Week 7: Ages 5-11 (August 11th - 15th) FULL

Week 8: August 18-22 (Ages 12-19) FULL

If you would like to register for the Summer Respite Programs, please select the summer program you are interested in

Kids Club (ages 5-12)

Teen Group (ages 13-19)

Adult Day Program (ages 18+)

Little Ones Play Group (ages 3-7)

Upon agreement, Opal Family Services can provide monthly invoicing for the Summer Respite Programs. Please select the appropriate option below:

Social Development has agreed to receive monthly invoicing

Jordan's Principle has agreed to receive monthly invoicing

Parent/Guardian has agreed to receive monthly invoicing

Other