Registration form for TLC

Parent/Guardian's Name *

First

Last

Parent/Guardian phone number

Parent/Guardian's Email *

Camper's Name *

First

Last

Camper's date of birth *

Camper's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Multiple Choice *

TLC 2 (April 25 - 27)
TLC 3 (Oct. 24 - 26)
TLC 4 (Dec 5 - 7)

Registration fee *

$25.00 + 3% cc fee - $25.75

Choose an amount you are able to pay (if any)

The "true cost" of a TLC weekend is $250. Our Trust-Based sliding scale allows families to pay what they can for the program and pay that amount at the time of registration (in addition to the required $25 registration fee). The second number represents the cost with the 3% cc fee.

Total Amount

$0.00

Square *

Card

Name on Card

Custom Captcha *

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