Bitter Lax Registration

Bitter Lax Registration

Please answer all of the questions.
15% off the price is offered for each additional Child
Select Camp Location *

Summer Day Camp: Cohasset, MA
Please Select Camp Session *

Session 1 - June 19 - June 22 = $400.00 Session 2: June 26 - June 29 = $400.00
Player's Details
How many Players are you signing up? *
Player's Name *

First Name Last Name
Player's Gender: *
Player's Grade *
Player's Age
Player's Date of Birth

Month Day Year
Time & Date Child 1
See you at {timeamp}
2nd Player's Name *

First Name Last Name
2nd Player's Gender: *
2nd Player's Grade *
2nd Player's Date of Birth

Month Day Year
Time & Date Child 2
See you at {timeamp152}
3rd Player's Name *

First Name Last Name
3rd Player's Gender: *
3rd Player's Grade *
3rd Player's Date of Birth

Month Day Year
Time & Date Child 3
See you at {timeamp153}
4th Player's Name *

First Name Last Name
4th Player's Gender: *
4th Player's Grade *
4th Player's Date of Birth

Month Day Year
Time & Date Child 4
See you at {timeamp154}
Parent's Details
Parent's Name *

First Name Last Name
Parent's Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Emergency Contact
Name *

First Name Last Name
Relationship *
Phone Number *
Please enter a valid phone number.
Email *
example@example.com
Payment Section
Promo Code
Total Before Discount
Discounted
Total For Payment