This registration form signs you up for the entire week!
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone:* Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info*
Students entered below will be added to your family's account
Additional Information:
I understand that a signed waiver will be required for all students participating in this event. Any student that does not have a waiver filled out and signed by parent or legal guardian will not be able to attend. I also understand NO REFUNDS will be given for waivers not filled out and signed on event date. Waiver can be found on our website at under Summer Camp.
I've read the above and agree.
Enter your Full Name: *   
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*