2048 Carmel Road
Charlotte, NC 28226
(704) 364-5713

Summer Camp Registration Form

Child's Name:



Child is Called:

Mother's Name:

Father's Name:

Street Address:


ZIP Code:


Home Phone:


Father's Mobile Phone:

Father's Work Phone:

Mother's Mobile Phone:

Mother's Work Phone:

Church Home / Affiliation

Please indicate which age group you wish to register:

Please indicate which weeks for which you wish to register:

Week 1: June 4-7
Week 2: June 25-28
Week 3: July 16-19
Week 4: July 23-26

Special Considerations (allergies, etc.):

The non-refundable Registration Fee must be submitted to finalize this registration. These fees can be paid online. Once you have submitted your registration form, you will be directed to a page to submit registration fees and tuition. You may also make checks payable to Carmel Presbyterian Weekday School (CPWS).

If registering multiple children, please complete this application form for each child.