Summer Camp Enrollment Form

Community & Family Development, sfc Inc. Summer Nights Basketball Registration

Fridays at 7:00pm - 9:00pm | Free Food| Safe Environment 8515 NE 25TH STREET SPENCER, OK 73084| In the Gym located on the north side of the property.
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade*
Name of School*
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
MEDICAL INFORMATION
Physician Name

First NameLast Name
Phone Number

Area CodePhone Number
Medical Concerns
Does your child need a ride Friday? Yes or No please provide your address. Pickup at 6:00pm and Dropoff at 9:45pm
Should be Empty:

Community & Family Development, sfc Inc. Summer Nights Basketball Registration