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Life Skills Prep Camp 2023 Registration
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Parent/Guardian Information

Emergency Contacts

Additional contacts if primary parent/guardian cannot be reached. At least one emergency contact must be listed.

Medical Information

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If yes above, click here to download medical form. Upload completed form below.

If answered YES above, please click here to download medical form. Please e-mail completed form to office@loristephensllc.com prior to camp dates.

Notes

How did you hear about us?

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Payment

Please choose  the session you would like to register for. We accept PayPal and all major credit cards. If you do not have a PayPal account or wish to pay with a card, choose "Pay with Debit or Credit."

Siblings, existing clients and booking multiple sessions qualify for a 10% discount. Discounts cannot be combined. 

If you want to register for multiple sessions, please fill out and submit separate forms for each session.

After 4/30/23, if you qualify for a discount via siblings, multiple sessions or current client, please contact us here to request a reimbursement.

Select an item ($)
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