Venture On Courage Camp Registration Form 2022

Venture On - Courage Camp Registration

For current Venture Academy students only
Student Information
Student's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade for 2024/2025*
T-Shirt Size (Supply is limited so actual size may vary)
Session Choice*

#1 Grade 3-5 (3 day workshop) July 8 - July 10, 2024 8:00am - 2:30 pm#2 Grade 6-8 (2 day workshop) July 11 - July 12, 2024 8:00am - 2:30 pm
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name*

First NameLast Name
Home Number*
Cell Number
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
Should be Empty:

Venture On - Courage Camp Registration