Dizzybus :: Summer Camps

Camper's Name *

First Last

Camper's Age

Gender

Birthday

Parent/Guardian Name(s)

Phone

### - ### - ####

Address

Street Address City State / Province / Region Postal / Zip Code Country

Email *

Special Notes About Camper

Second Camper

If you would like to register a second camper please fill out the following section if they are to be registered for the same days as the first camper, if you would like them registered for different days please fill out a new form.

Second Camper's Name

First Last

Second Camper's Age

Second Camper's Gender

Second Camper's Birthday

Camp Days

Select Camp Days and Times

Week 1: Camping in Canada
(6/18 - 6/22)

Mon

Tues

Wed

Thurs

Fri

Week 1:

Week 2: Under the Sea in Australia (6/25-6/29)

Mon

Tues

Wed

Thurs

Fri

Week 2:

Week 3: Fiesta in Mexico (7/2 – 7/6, no camp on Wednesday, 7/4)

Mon

Tues

Thurs

Fri

Week 3:

Week 4: Tropical Rainforest in the Amazon Jungle (7/9 - 7/13)

Mon

Tues

Wed

Thurs

Fri

Week 4:

Week 5: Royalty of Great Britain (7/16 - 7/20)

Mon

Tues

Wed

Thurs

Fri

Week 5:

Week 6: Fossil Dig in the Sahara (7/23 - 7/27)

Mon

Tues

Wed

Thurs

Fri

Week 6:

Week 7: Beach Party in Thailand (7/30 - 8/3)

Mon

Tues

Wed

Thurs

Fri

Week 7:

Week 8: Wild West in Texas
(8/6 - 8/10)

Mon

Tues

Wed

Thurs

Fri

Week 8:

Week 9: Pirates & Mermaids of the Pacific Ocean (8/13 - 8/17)

Mon

Tues

Wed

Thurs

Fri

Week 9:

Week 10: Back home to Dizzy's Big Top Circus (8/20 - 8/24)

Mon

Tues

Wed

Thurs

Fri

Week 10:

Week 11: Mystery Week
(8/27 - 8/31)

Mon

Tues

Wed

Thurs

Fri

Week 11:

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Payment Options

We require a 50% of the camp total and the remainder will be due on the first day of camp each week.

Card Type

Name on Card

Card Number

Expiration Date

Billing Zip Code

Paypal

Yes, I'd rather use PayPal

Check here if you'd rather be billed through PayPal (will be sent through email)