Camp Registration Form

CIRCUS SUMMER HOLIDAY CAMP
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Contact us at (62) 361 – 9002655 / (62) 811 399 2277 or
email bookings@balicircus.com

Choice of days:

Drop-In Date (yy-dd-mm)

Price includes morning snacks, lunch and all equipment.
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Child Name 1 (required)

Child Age (required)

Child Name 2

Child 2 Age

Parent/Guardian Name (required)

Your Email (required)

Phone Number (required)

Does your child have food allergies?

If yes,

Please indicate if there is anything
we need to know about your child
prior to the beginning of the camp

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The spaces for this camp are limited.
So please register for this program at your earliest convenience to guarantee the week(s) of choice.