IMPORTANT: ONLY FILL OUT THIS FORM IF YOUR CHILD IS ALREADY REGISTERED AND YOU WOULD LIKE TO MAKE A PAYMENT OR PAY OFF THE BALANCE WITH A CREDIT CARD. ALL FIELDS WITH AN ASTERISK (*) ARE MANDATORY

* Camper's Name:   * Parent's Name:   * Parent's Phone:   - - * Name on Credit Card:   * Select Credit Card: Visa/MC/Discover | AmEx If Visa: * Card Number: --- If AmEx: * Card Number: -- * Credit Card Security Code:   (What's This?) * Expiration Date (mm/yy):   * Amount to be Charged:   $ Please note: There will be a 3% surcharge on all credit and debit card charges.

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