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678 Explosion
Middle School Summer Camp
For Students in Grades 5th-8th
When: July 14-18, 2008
Where: Stetson University in Deland, FL
Deposit of $100.00 Due ASAP
Limited Space Available!!
Cost: $325.00 Due by June 1st

Student's Name:
Address:
City: State:
Phone: 

Grade:  Gender:

Special Needs

Parent/Guardian Information

Name:
Phone:  Cell:
Email:
Alternate Address (if applicable)

*Click here to download the waiver and release form - When completed return completed and signed form to The Grace Place by:

1. Mail form to 1550 S.E. Salerno Road Stuart, Fl. 34997 Attn: Eric Addison

2. Return form to The Grace Place main office Mon - Fri from 8 am - 5 pm 
Attn: Eric Addison
3. Send the completed form with your student to youth group

Click below to Submit your registration and pay. You will be directed to an online payment page. Please put "Middle School Summer Camp" in the designation box.