Student's Name *

First Name

Last Name

Student's Birthdate *

MM

DD

YYYY

Student's Cell Phone

(###)

###

####

Guardian's Cell Phone *

(###)

###

####

Don't Forget! *

We need all three of items listed below before your student is officially signed up for camp. Please confirm that you will follow through.

I will complete the Payment for camp

I will complete the Medical Release

I will complete the Photo Release