Registration Form June 2-3

Kids Registration Form

Please fill out your child's details and emergency contacts to complete the registration.
Child's Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Consent
Emergency Contact #1 Name
Emergency Contact #1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact #2 Name
Emergency Contact #2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Food Allergies (if any)
T-Shirt Size

Safari Camp Registration

Safari Camp Registration for dates June 2-3 with applicable fees and taxes

$165.31 Quantity

Total

Credit Card

Apple Pay

Kids Registration Form