CJJ Youth Summer Camp July 21st -25th 9am-1pm
Ages 6-14
Camper's Name
*
First Name
Last Name
Camper's Birth Date (ages 6+)
*
Please select a year
2026
2025
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Year
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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Day
Parent or Legal Guardian
*
First Name
Last Name
Parent Phone Number:
*
-
Area Code
Phone Number
E-mail (for camp information and invoicing)
*
Camper's T-Shirt Size
*
Please Select
Youth Small
Youth Medium
Youth Large
Youth Extra Large
Adult XS
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Adult 3XL
For camp participant
Camper's current or Previous Training Location(s)
experience not required
Camper's current Rank/Experience Level (ie white belt, grey belt. "none" if no experience.)
experience not required
Does camper have any medical history or conditions that could affect their ability to participate in contact sports?
*
No
Yes (Please enter details)
Medical Conditions
Does camper have asthma or allergies, (including food allergies)?
*
No
Yes (Please enter details)
asthma or allergies
Where did you hear about our Camp?
A Friend or colleague
Social Media (Facebook, Instagram)
Online Search (Google, Bing, Yahoo)
Local Advertisement/ Activities Listing
News Article
Current CJJ Member
Other
Secondary Emergency Contact
*
First Name
Last Name
Secondary Emergency Contact Phone Number
*
-
Area Code
Phone Number
Secondary Emergency Contact Relation
*
Please Select
Parent
Spouse/Partner
Extended Family
Friend
Other
Summer Camp Payment Policy
Spots are limited, payment is required to secure spot. Spots are transferable but not refundable. Transfer requests are required at least 7 days prior to camp.
My Products
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( X )
Non-Member Camper
$
150.00
reserves 1 camper spot for non CJJ member
Current CJJ Member
$
125.00
reserves 1 camper spot for current CJJ member (verification required)
Total
$
0.00
Type a question
Disclaimer and Waiver of Liability
*
I have read, understood, and accept the disclaimer and liability waiver and sign it of my own free will
Sunscreen Consent Statement
*
I understand that outdoor activities are part of the Canby Jiu Jitsu Summer Camp experience. I agree to send my child with sunscreen each day, otherwise I give permission for camp staff to apply a standard spray or lotion sunscreen (SPF 30 or higher) to my child as needed.
Current CJJ Members only: If needed, are you or another guardian interested in volunteering for the camp?
Yes, I'm available all week
Yes, available 1 or more days
Yes, available for 1st day registration support
Yes, available for Friday Field Day Activities
Yes, available for pre-camp set up
No, unfortunately I am not available
Signature of Legal Guardian
*
Choose your payment method:
(please reach out to canbyjiujitsu@gmail.com if you would like to pay with cash or check, payment will be needed to reserved spot.)
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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