DISCOVER YOUR PASSION SUMMER PROGRAM
CAMP REGISTRATION FORM
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Student Name
*
English Name
Full name on ID
Gender
Male
Female
N/A
Date of Birth
*
-
Day
-
Month
Year
Date
Student Height (cm)
*
Which camp dates?
*
Fall Mid-Term Break October 11-15
Child 1 Total
Would you like to register a second child?
2. Student Name
*
First Name
Last Name
2. Gender
Male
Female
N/A
2. Date of Birth
*
-
Day
-
Month
Year
Date
2. Student Height (cm)
*
2. Which camp dates?
*
Fall Mid-Term Break October 11-15
Child 2 Total
Would you like to register a third child?
3. Student Name
*
First Name
Last Name
3. Gender
Male
Female
N/A
3. Date of Birth
*
-
Day
-
Month
Year
Date
3. Student Height (cm)
*
3. Which camp dates?
*
Fall Mid-Term Break October 11-15
Date
-
Day
-
Month
Year
Date
Camp Price
Child 3 Total
Form Total
Discount Code
DISCOUNT AMOUNT
=TOTAL!!
MultiWeek
Apply Multi-Week discount?
Yes Please! (5% discount)
No Thanks
Parent/Guardian Information
Persons approved for pick-up from camp (please insert multiple if required)
Email
*
example@example.com
Phone Number
*
-
Phone Number
Where did you here about our camp?
*
We already do lessons with PGA Youth Development
We are students at Dalton School
At the Waterfall facility
Facebook / Instagram ads
Other
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