Absolutely Positively Creative Kids' Kamp

Send replies by Friday, June 30th, 2006 with payment made to Rialto Kids Kamp to:

Rialto
P.O. Box 176
Morrilton, AR 72110

REGISTRATION

Student Name                                                                               

Home Address                                                                               

City/State/Zip                                                                               

Age                      Date of Birth                              Grade             

Parent/Guardian Name                                                               

Daytime Phone                                Cell Phone                           

T-Shirt Size - Circle One Below

Youth -     S        M        L        XL

Adult -     S        M        L        XL        XXL        XXXL