Camp Registration

*Today's Date

Month

Day

Year

You must be the parent or legal guardian to register someone under the age of 18.

*Primary Parent/Guardian

Full Name

Email Address

Phone Number

Street Address

City

State

Zip Code

*Authorization

Please list the names of EACH individual (including yourself) authorized to pick up the child participant from the program (separate names with a comma).

Authorized names

No child participant will be released to any individuals NOT listed on this form. ALL authorized pick-up individuals must present photo-identification upon pick-up each day of camp.

*Camp Choice

*Name

Participant full name

*Birthday

Month

Date

Year

*Gender

*Allergies

Does the child have any allergies? If yes, please describe:

*Restrictions

Does the child have a disability, including medical, behavioral, or physical restrictions? If yes, please describe:

NOTE: Please complete one registration form for each child attending.

After completing the registration form, you will receive a confirmation email with a link to complete your registration payment.

Your camper’s spot will be secured once payment is received.

Please allow 24-hours for registration response.