Track Out Rock Camp at We Rock the Spectrum

Track Out Camp! Registration Form

This Registration form is required before we can enroll your child in Track Out
NOTES:

This form has expired, please use the following form for 2024/2025

2024/2025 Track Out / Day Camps
Have you previously registered your child for Track out, Holiday, Teacher Workday or any other Day camp before? (excludes Summer Camp 2023)*

YesNo
Thank you!

You do not need to re-register your child for Camp.

Please use the following form for returning camper requests:

Returning Camper Request

Requests must be made at least 3 days prior to the requested days

We will follow up via email with confirmation of your request and if we have availability to add your child to the requested days.
Please do not assume acceptance until you have received confirmation
As a returning camper, your request is moved to the front of the processing list.
Thank you!
You may continue with registration.

Requests must be made at least 3 days prior to the requested days to allow us time to process your request.

We will follow up via email with confirmation of your request and if we have availability to add your child to the requested days.

Please do not assume acceptance until you have received confirmation.

Camper's Information
NOTE - Age out for this camp is 10 years old. If your child is older than 10 years old, please do not fill out this form and email us for more info - info@werockthespectrumcary.com
Member ID - From Mindbody
Camper Name*
Nickname or Preferred Name
Date of Birth*

MonthDayYear
Current Age*
Please Select Your Childs Track*
School Camper Attends*
Please Select your Camp Option*
Select the Full Weeks you would like your Child to attend*

Week 42 Onwards - Please Use Summer Camp Form
Select the Weeks you would like your Child to attend*

Week 42 Onwards - Please Use Summer Camp Form
Days of the week you would like your Child to attend*

MondayTuesdayWednesdayThursdayFridayOther

Emergency Contacts/Authorized Pickup

In a single parent/guardian household the primary person cannot be listed as the emergency contact. The second parent/guardian may be listed, however it is our preference to list someone not in the household. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18.
Emergency Contact #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number*
Use Primary if no other #
Relationship to Child*

Statement of Understanding
You as the Parent/Guardian, hereby declare and affirm that all information provided in this form is accurate and complete to the best of your knowledge. You understand that any false or misleading information may result in the immediate removal of your child's from the camp program.*
Type first and last name above to consent
This form, after being completed and signed by the parent/guardian, must be reviewed for completeness and accepted by the camp administrator prior to the child being accepted into the program. After the child has attended the program the administrator shall have the parent/guardian review and initial the form when any changes/updates are made and at least annually. The parent/ guardian and the administrator or designee shall initial and date the form in the section below to indicate when the form was last reviewed.*
Type first and last name above to consent
Sign Document*
Date Signed*

MonthDayYear
After you click submit, an initial window will open with Jotform sign, just acknowledging that you are signing the registration form.
Once that is complete, you will be re-directed to Stripe's payment portal to pay for the registration. Once complete you will see a thank you page
Registration Fees
prevnext( X )
Camp Registration Fee$50.00
Track Out & Summer Camp Registration fee. Please note that this fee is non-refundable but will be put toward your first camp payment.

Quantity

Total $0.00
Should be Empty: