SUMMER CAMP
2024
Parent's First Name
*
Parent's Last Name
*
Phone
*
Email
*
Student's Name
*
Choose Camp Week(s)
Summer Camp Week I (June 17-21)
Summer Camp Week II (June 24-28)
Summer Camp Week III (July 29- Aug 2)
Summer Camp Week IV (Aug 5-9)
Camper T-Shirt Size - choose one
*
Camper T-Shirt Size - choose one
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
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Student’s Medical History/Conditions
*
MEDICAL INSURANCE COMPANY NAME
*
POLICY NUMBER AND GROUP NUMBER
*
Print Name of Parent/Guardian
*
Signature of Parent/Guardian 1
*
Clear
Please Upload a copy of your driver's license
*
Please Upload a copy of your driver's license
Submit
