2021 Summer Camp Registration
Player's Information
Last Name
*
First Name
*
Middle Name
*
Gender
*
Male
Female
Address
*
City
*
State
*
Zip
*
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
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1927
1926
1925
1924
1923
1922
1921
1920
Year
Grade entering in the fall
*
Please Select
College
Senior
Junior
Sophomore
Freshmen
8th
7th
6th
5th
4th
3rd
2nd
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?
Please Select
Friend
Church
Web
Promotional Event
Other
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
Electronic signature, please initials
*
*No Refunds*
My Products
*
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( X )
1 Day Camp
$
50.00
1 Day Intro Camp
Half Day Camp
$
169.00
Half Day Camp
How Many Weeks
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Fullday Camp
$
199.00
Full Day Camp 8:30 - 5 PM
How Many Weeks
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Practice T-Shirts
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
T-Shirt
XS
S
M
L
XL
XXL
XXXL
Enter coupon
Apply
Subtotal
$
0.00
Tax
$
0.00
Total
$
0.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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