Summer Camp Enrollment Form

Registration

Town of Rocky Ford Teen Cooking class
CHILD INFORMATION:
Child Name

First NameLast Name
Birth Date

MonthDayYear
Grade
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Food Allergens
Please select the dates you plan to attend
Should be Empty: