Kid's Camp Registration

Camper Participant Info

Child's Name

Child's Grade

Contact Email

This address will receive a confirmation email

Student Phone

T-shirt size

Adult S Adult M Adult L

Any food allergies?

Any Medications?

Any special instructions?

Emergency Contact Info

Parent Name

Parent Email

This address will receive a confirmation email

Parent Phone

Payment

There is $1.75 transaction fee included when paying online.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

July 20-24

Please fill out this form and click submit.