2021 CNLA Registration Form

2021-2022 Camp NOW Leadership Academy

Virtual Leadership Academy Registration Form
Participant Name *

First Name Last Name
Birth Date *

Month Day Year
Name of School *
Self-Identified Pronoun
He/Him Her/She They/Them
Shirt Size *
Parent/Guardian *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Parent/Guardian E-mail *
Parent/Guardian Mobile Number *

Area Code Phone Number
Parent/Guardian Work Number

Area Code Phone Number
Camp Now Leadership Academy Payment
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USD Camp Now Leadership Academy Registration Payment

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

2021-2022 Camp NOW Leadership Academy