Camp Fun Quest Registration Form

2021 Summer Camp Registration
Player's Information
Last Name *
First Name *
Middle Name *
Gender *

Male Female
Address *
City *
State *
Zip *
Birth Date *

Month Day Year
Grade entering in the fall *
Choose You Weeks *

Week 1: May 3-7 Week 2: May 10-14 Week 3: May 17-21 Week 4: May 24-28 Week 5: May 31-June 4 Week 6: June 7-11 Week 7: June 14-18 Week 8: June 21-25 Week 9: June 28-July 2 Week 10: July 5-9 Week 11: July 12-16 Week 12: July 19-23 Week 13: July 26-30 Week 14: August 2-6 Week 15: August 9-13
Which camp would your child like to attend

Option 1: Youth Fundamental Camp Option 2: College / HS Intense Camp
Parent or Legal Guardian Information
Parent/Legal Guardian *
Relation *
Work Phone *

Area Code Phone Number
Cell Phone

Area Code Phone Number
Parent /Legal Guardian 2 *
Relation 2 *
Work Phone 2 *

Area Code Phone Number
Cell Phone 2

Area Code Phone Number
Home Phone *

Area Code Phone Number
Emergency Contact Info
Emergency Contact Name(if parent or guardian is not avaliable) *
Emergency Number *

Area Code Phone Number
Emergency Number #2 *

Area Code Phone Number
Email Confirmation
Parents Email (camper confirmation will be sent by email, if left blank it will be mailed)
Camper's Email
Other Information
How did you hear about Camp FunQuest?
First Time Summer Camper? *

Yes No
Health Information

A health officer is on site at all times.
Are immunications up to date?

Yes No
Date of last tetanus shot
Any activity the camper should be restricted from?
Any physical, mental or other condition that would require special attention or medication while at camp?
List all medications, both prescribed and over the counter, all medications will be turned into the health officer except rescue inhalers, bring all medication in original containers.
List any allergies (ex: bees,peanuts, dairy)
Any dietary needs that we should know about?
Camper Photo Release
I agree that photos of my child can be taken on used on for camp social media purposes

Yes No
- Be certain to enter your email address correctly on the registration form to receive confirmation via email with in 2 weeks
By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named camper by authorized personnel. The camp carries secondary insurance. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activites.
Electronic signature, please initials *

My Products *

1 Day Camp $ 50.00

1 Day Intro Camp

Half Day Camp $ 169.00

Half Day Camp

How Many Weeks

Fullday Camp $ 199.00

Full Day Camp 8:30 - 5 PM

How Many Weeks

Practice T-Shirts $ 25.00

Quantity T-Shirt

Enter coupon

Subtotal $ 0.00 Tax $ 0.00 Total $ 0.00

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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

Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

2021 Summer Camp Registration

Player's Information

Parent or Legal Guardian Information

Emergency Contact Info

Email Confirmation

Other Information

Health Information

Camper Photo Release