2024 G.T.A.L Elite Summer Camp Registration

Parents' Information

Parent/Guardian 1
Parent/Guardian 1 (Primary Point Of Contact)*

First NameLast Name
Relationship to Child*
E-mail*
example@example.com
Cell Phone*

Area CodePhone Number
Upload a photo of your Drivers License

Browse Files

Cancelof
Home Phone*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work/School Name
Or enter N/A if not applicable
Parent's Work/School Phone

Area CodePhone Number
Parent's Work/School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would you like to be reached while your child is at camp?

Cell PhoneWork PhoneHome Phone
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Parent/Guardian 2
Parent/Guardian 2

First NameLast Name
Relationship to Child
E-mail
example@example.com
Cell Phone

Area CodePhone Number
Home Phone

Area CodePhone Number
Home Address Same as Parent/Guardian 1?

Yes
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work/School Name
Or enter N/A if not applicable
Parent's Work/School Phone

Area CodePhone Number
Parent's Work/School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would parent/guardian 2 like to be reached while your child is at camp?

Cell PhoneWork PhoneHome Phone

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. 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/Authorized Pick-up #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*

Area CodePhone Number
Secondary Phone Number*

Area CodePhone Number
Relationship to Child*
Cell Phone provider *
ex: VERIZON
Emergency Contact/Authorized Pick-up #2
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*

Area CodePhone Number
Secondary Phone Number*

Area CodePhone Number
Relationship to Child*
Emergency Contact/Authorized Pick-up #3

Optional
Full Name

First NameLast Name
Relationship to Child
Primary Phone Number

Area CodePhone Number
Emergency Contact/Authorized Pick-up #4

Optional
Full Name

First NameLast Name
Relationship to Child
Primary Phone Number

Area CodePhone Number

2025 G.T.A.L Summer Camp Registration Form = Start Date June 23, 2025 - August 15, 2025 (Ages 5 yrs Fully potty trained - 13 yrs old)

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