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Registration: Summer Camp 2009
Participants' Info
Child's Name
(required)
Child's DOB
(required)
Child's Age
(required)
Child's Sex
Choose
Male
Female
Address
(required)
Parents Info
Email Address
(valid email required)
Mother's Name
Work Phone
Home Phone
Father's Name
Work Phone
Home Phone
General Info
Camp / Event you are interested in attending
Preferred Date
July 13-17
(required)
School / League
Preferred Position
Emergency Contact / Medical Details
Emergency Contact Name
(required)
Phone Number
(required)
Insurance carrier
(required)
Policy / ID Number
(required)
Allergies
(required)
Physical Limitations
Does your child have any physical limitations?
Choose
Yes
No
(required)
If yes, please explain
Payment Info
Intended method of payment
Choose
Online
Mail Check
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"Teamwork makes the dream work."
Contact Details
Please call us for more information, or complete our
contact form
and one of our staff will contact you within 2 business days.
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