JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
MARCH at the PARC - Registration*
*Once your registration has been processed, you will receive a link for confirmation and payment.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Boulder Parc Climb Gym March Break Camp - March 14-18, 2021
1st Child's Name
*
Your answer
1st Child's Date of Birth
*
MM
/
DD
/
YYYY
2nd Child's Name
Your answer
2nd Child's Date of Birth
MM
/
DD
/
YYYY
3rd Child's Name
Your answer
3rd Child's Date of Birth
MM
/
DD
/
YYYY
Address
*
Your answer
Parent/Guardian Name
*
Your answer
Authorized Pick-up/Drop-off Person(s)
Your answer
Phone Number
*
Your answer
Emergency Contact Name, Relationship
*
Your answer
Emergency Contact Phone Number
*
Your answer
Emergency Contact Alternate Phone Number
Your answer
Will your child require early drop-off and/or late pick-up?
*
Yes
No
If yes, which day(s)
Monday
Tuesday
Wednesday
Thursday
Friday
Full Week
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
Your answer
Is the athlete prescribed an inhaler? If yes, please explain any instructions.
Your answer
Photo Release - I hereby give permission for my child's photo taken during March at the PARC to be used for publication/marketing by Boulder Parc.
*
Yes
No
Required
Is there anything else you'd like us to know?
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Project Bouldering Inc..
Report Abuse
Forms
