Camp Registration Form
These forms are required for your children to attend camp. !!DATE CHANGE!! Camp Dates are June 10-12th from 8:00 - 12:00. Early drop off is available! Please Let me know if you have any questions 662-299-8238.
Camper's Information
Camper Name
*
Entering Grade in 2023/24
*
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Other
AGE (Summer Camp is for ages 4-8)
T-Shirt Size
Please Select
YS
YM
YL
AS
AM
AL
AXL
AXXL
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Additional Camper Name
First Name
Last Name
Age
Tshirt Size
Additional Camper Name
First Name
Last Name
Age
Tshirt Size
Additional Camper Name
First Name
Last Name
Age
Tshirt Size
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Emergency Contact #1
Emergency Contacts/Authorized Pickup
Full Name
*
First Name
Last Name
Primary Phone Number
*
Relationship to Child
*
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allow child to be given bug spray such as OFF?
*
Yes
No
Please list and explain any allergies
*
0/150
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Parents' Information
Parent/Guardian 1
Parent/Guardian 1
*
First Name
Last Name
Relationship to Child
*
E-mail
*
example@example.com
Cell Phone
*
My Products
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CAMPER
$
200.00
ADD ON
Please select number of add on children
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Pay half now and half on camp day
The rest will be due on first day of camp.
$
100.00
Save
SUBMIT
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