CBC SUMMER CAMP FORM
TENNIS CAMP
Number of children joining
*
Please Select
1 child
2 children
3 children
4 children
1st Child's Name
*
First Name
Last Name
1st Child's Birth Date
*
-
Month
-
Day
Year
Date
2nd Child's Name
First Name
Last Name
2nd Child's Birth Date
-
Month
-
Day
Year
Date
3rd Child's Name
First Name
Last Name
3rd Child's Birth Date
-
Month
-
Day
Year
Date
Parents Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Full Day/Half Day
Half Day Member - $220
Full Day Member - $450
Half Day Non-Member - $270
Full Day Non-Member - $500
Week 5
Half Day Member - $132
Full Day Member - $270
Half Day Non-Member - $162
Full Day Non-Member - $300
Weeks
*
Week 3: July 13th - 17th
Week 4: July 20th - 24th
Week 6: August 3rd - 7th
Week 7: August 24th - 28th
Member or Non Member
*
Please Select
Member
Non Member
Members
Membership Number
Credit Card Details (Non Members Only)
First 8 Digits
Last 8 Digits
Name on Card
Card Number
Expiration Date
CVC
Postal / Zip Code
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Do you give consent for photos to be taken of your child for CBC Promotional material?
*
I give consent
I do not give consent
Do you give permission for our counselors to apply sun block to your child when needed?
*
Yes
No
Allergies/ Dietary Restrictions/ Additional Information for all children
All swimming will take place at the CBC pool, please inform us of your child's swimming abilities. (Full Day kids only)
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