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Summer Camp Detailed Registration Form
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1
Teen's Information
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2
Teen's Name
First Name
Last Name
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3
Birth Date
-
Month
Day
Year
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4
Grade
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5
Gender
Male
Female
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6
Parent/Guardian Information
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7
Name
First Name
Last Name
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8
Phone Number
Home or Cell
Area Code
Phone Number
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9
E-mail
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10
Emergency Information
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11
Emergency Contact's Name
First Name
Last Name
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12
Relationship
Please Select
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Babysitter/Nanny
Other
Please Select
Please Select
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Babysitter/Nanny
Other
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13
Phone Number
Area Code
Phone Number
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14
Alt. Phone Number
Area Code
Phone Number
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15
Please list or identify allergies or medical conditions
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16
Are you okay with your son/daughter using power tools?
YES
NO
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17
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