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Required fields are marked with asterisks (*)

Day Camp Registration Application

Please complete the following Day Camp registration application form. Please note that no payment will be taken until your camper has been accepted into the program.

Child's First Name

Child's Last Name

Child's Age

Child's Birth Date

Parent/Guardian's Name

Address

Parent's Cell Phone Number (Primary Number)

Email Address

Emergency Contact #1 (Name)

Emergency Contact #1 (Relationship)

Emergency Contact #1 (Primary Number)

Emergency Contact #2 (Name)

Emergency Contact #2 (Relationship)

Emergency Contact #2 (Primary Number)

Contact(s)

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Day Camp Registration Application

I'd Like To...

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