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 (5pm-7pm): Cohasset, MA
Please Select Camp Session
*
Session 1: June 26 - June 29 = $275.00
Player's Details
How many Players are you signing up?
*
Please Select
1
2
3
4
Player's Name
*
First Name
Last Name
Player's Gender:
*
Please Select
Male
Female
Player's Grade
*
Please Select
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Player's Date of Birth
-
Month
-
Day
Year
2nd Player's Name
*
First Name
Last Name
2nd Player's Gender:
*
Please Select
Male
Female
2nd Player's Grade
*
Please Select
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
2nd Player's Date of Birth
-
Month
-
Day
Year
3rd Player's Name
*
First Name
Last Name
3rd Player's Gender:
*
Please Select
Male
Female
3rd Player's Grade
*
Please Select
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
3rd Player's Date of Birth
-
Month
-
Day
Year
4th Player's Name
*
First Name
Last Name
4th Player's Gender:
*
Please Select
Male
Female
4th Player's Grade
*
Please Select
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
4th Player's Date of Birth
-
Month
-
Day
Year
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
Total Payable
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USD
Credit Card
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