Band Together Summer Camp Registration Form

Band Together Summer Camp Registration
Camper's Information

Personal & Health
Name

First NameLast Name
Birth Date

MonthDayYear
Age (at time of camp)
Grade (entering this fall)
List Any Allergies and Dietary Restrictions
Medications & Frequency
Parent / Guardian Information

(All correspondence and and invoices will be sent to this person)
Name

First NameLast Name
Email
example@example.com
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship with the Camper
Emergency Contacts and Authorized Pick Up Persons
Program Information

Program & Transportation & Payment
Select Camp Week
Select Camp Type
Payment Type
Should be Empty:

Band Together Summer Camp Registration