PAINTBOX SUMMER CAMP REGISTRATION FORM
Please return to Jeanne Waxgiser, Paintbox Preschool, 321 High Street, Cumberland, RI 02864
Child’s Name:
Date of Birth M/D/YR: _______________
Address (Street, Town, State, Zip):
______________________________________________
Home Phone Number: ________________ Cell Phone:________________
Email: _______________________________
Does the child have any allergies? Yes _____ No _____ Please list: __________________________________________
Name the camp/s you are registering for: ______________________________________
_______________________________________________________________________
Please submit half of the balance due to hold a spot.
Total Amount Due is $100 per camp 
Amount Sent: ________________________
