Camp Registration Form
Thanks for signing up for CTMS Esteem Building Camp. To book for a place in the camp, you must complete the form below accurately. Students must currently be in grades 5-8. Camp enrollment is from June 28-July 29, 2022, Monday - Thursday 10a.m.- 3p.m. lunch and snacks are provided. The cost of camp is $100 a week per child and $175 (2 children) $75 per additional child. Someone will contact you to schedule orientation on or before the week of June 13, 2022.
Child #1 Name:
*
First Name
Last Name
Birth Date:
*
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School Name
*
Current Grade
*
5th
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8th
Select Camp shirt size:
*
Small
Medium
Large
Extra-large
Child #2 Name:
First Name
Last Name
Birth Date:
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February
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December
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1926
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1920
Year
School Name
Current Grade
5th
6th
7th
8th
Select Camp shirt size:
Small
Medium
Large
Extra-large
Child #3 Name:
First Name
Last Name
Birth Date:
January
February
March
April
May
June
July
August
September
October
November
December
Month
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
School Name
Current Grade
5th
6th
7th
8th
Select Camp shirt size:
Small
Medium
Large
Extra-large
Would you like to register any additional children? If so please list all names, schools, grades, birthdays, and t-shirt sizes here.
Please provide any medical or dietary restrictions you have. You will be required to provide medical documentation.
How did you hear about Camp?:
*
Email
Facebook
Print Ads
Radio
Referral
School Official
Others
Back
Next
Family Information
Parent/Guardian's Name:
*
First Name
Last Name
Contact Phone Number:
*
-
Area Code
Phone Number
E-mail Address:
*
Back
Next
Emergency Contact and Pick-Up Information
Students will only be released to the names provided and I.D. is required. All names on the pick-up list must be over the age of 18.
Emergency Contact Name:
*
First Name
Last Name
Emergency Contact Phone Number:
*
-
Area Code
Phone Number
Relationship to Student:
*
Emergency Contact Name:
*
First Name
Last Name
Emergency Contact Phone Number:
*
-
Area Code
Phone Number
Relationship to Student:
*
Emergency Contact Name:
*
First Name
Last Name
Emergency Contact Phone Number:
*
-
Area Code
Phone Number
Relationship to Student:
*
Back
Next
Your Reason For Attending This Camp
In 300 words or less, please describe your reasons for wishing to attend this camp.
*
0/300
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