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Camp Registration Form
Join Us for Camp Willows this Summer!
2026 Willows Camp Registration
Step
1
of
4
25%
Willows Membership
(Required)
Bonded Member
Non-Bonded Member
Not a Member of the Willows
Child #1 Information
Child #1 Name
(Required)
First
Last
Child #1 Age
(Required)
5
6
7
8
9
10
11
12
13
Any medical conditions (ex. asthma, use of epi pen, allergies)
(Required)
If none please enter N/A
Child #2 Information
Child #2 Name
First
Last
Child #2 Age
N/A
5
6
7
8
9
10
11
12
13
Any medical conditions (ex. asthma, use of epi pen, allergies)
If none please enter N/A
Guardian Details
Guardian Name
(Required)
First
Last
Guardian Email
(Required)
Enter Email
Confirm Email
Guardian Phone
(Required)
Camp Registration
Please let us know the weeks that you wish to register your child(ren) for.
Child #1: Weeks of Camp
Week #1: Little Scientist
Week #2: Minecraft Box Builders
Week #3: Out of this World
Week #4: NJRT
Week #5: Recycling Art
Week #6: NJRT
Week #7: Fortnite Battle camp
Week #8: Survival Island Part 2
Select All
Please note that Theater week is an extra $50 per child.
Child #2: Weeks of Camp
Week #1: Little Scientist
Week #2: Minecraft Box Builders
Week #3: Out of this World
Week #4: NJRT
Week #5: Recycling Art
Week #6: NJRT
Week #7: Fortnite Battle camp
Week #8: Survival Island Part 2
Select All
Please note that Theater week is an extra $50 per child.
Child #1: Weeks of Camp
Week #1: Little Scientist
Week #2: Minecraft Box Builders
Week #3: Out of this World
Week #4: NJRT
Week #5: Recycling Art
Week #6: NJRT
Week #7: Fortnite Battle camp
Week #8: Survival Island Part 2
Select All
Please note that Theater week is an extra $50 per child.
Child #2: Weeks of Camp
Week #1: Little Scientist
Week #2: Minecraft Box Builders
Week #3: Out of this World
Week #4: NJRT
Week #5: Recycling Art
Week #6: NJRT
Week #7: Fortnite Battle camp
Week #8: Survival Island Part 2
Select All
Please note that Theater week is an extra $50 per child.
Camp
Before/After Care Registration
Camp Hours are 10:00am-3:00pm. We are offering before care from 9:00-10:00am ($30/week/per child), and after care from 3:00-5:00pm ($40/week/per child). If you are not interested in before or after care you can click next on the bottom of the screen.
Before Care (9:00-10:00am)
1 Child
2 Children
N/A
How many weeks of before care
After Care (3:00-5:00pm)
1 Child
2 Children
N/A
How many weeks of after care
Subtotal
$0.00
Payment Details
Please choose ACH or Credit/Debit for payment. We do not accept payment at the door, therefore no cash or checks.
Bonded Member Discount (40% off)
$0.00
Bonded Members: $150 Non Bonded & Non Members: $250 Theatre Week is an additional $50 for everyone
Total
ACH
Account Number
Account Type
Select
Savings
Checking
Routing Number
Account Holder Name
Credit Card
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Security Code
Cardholder Name
Name
First
Last
Name
First
Last
Order Token
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