Creek Kids Summer Camp 2026 Registration
Parent/Guardian Information
Parent/Guardian First Name
*
Parent/Guardian Last Name
*
Parent/Guardian Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email
*
example@example.com
Member Status
*
Please Select
Member – $150 per session
Non-member – $175 per session
Select Session(s)
*
Session 1: July 13–16
Session 2: July 27–30
Camper Information
Camper First Name
*
Camper Last Name
*
Camper Age (6–12 years)
*
Camper Rising Grade
*
Please Select
1st
2nd
3rd
4th
5th
6th
7th
T-shirt Size
*
Please Select
Youth XS
Youth S
Youth M
Youth L
Youth XL
T-shirt size is guaranteed if registered by July 6 (Session 1) or July 20 (Session 2).
Dietary Restrictions or Allergies
A snack will be provided each day, but campers may bring their own snack.
Medical Conditions
Emergency Contact & Pick Up Info
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Emergency Contact Name
Additional Emergency Contact Relationship
Additional Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Pick Up
If the parent/guardian listed above is not picking up camper, please list designated person(s).
I understand camp runs 9:00am–12:00pm and camper must be picked up by 12:00pm.
*
I acknowledge
Liability Statement
By signing below and/or checking the acknowledgement box, I acknowledge and agree that I release, waive, and hold harmless The Creek, its officers, employees, volunteers, and agents from any and all liability for any injury, loss, or damage to person or property arising out of participation in Creek Kids Summer Camp activities, except for acts of gross negligence or willful misconduct. I agree to follow all camp rules and safety instructions. I understand the risks involved and voluntarily assume them on behalf of myself and/or my child.
Type your full name in acknowledgement of Liability Statement:
*
Payment
My Products
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( X )
$150 (Members)
$150.00
$
150.00
$175 (Non-Members)
$175.00
$
175.00
Register
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