Alameda Ping Pong Gym Kids Summer Camp Registration

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Please fill out a form for each separate participant.
Payment to coach Johnny Tat through Venmo (@johnnyt2050) or Zelle (1-510-909-3558) as well as completing this form will finalize registration and reserve your spot.

Email *

First Name of the Participant *

Last Name of the Participant *

Phone Number of the Participant (if applicable)

Which week of summer camp will the participant be attending? *

6/12-6/16 half day AM

6/12-6/16 half day PM

6/12 -6/16 full day

6/19-6/23 half day AM

6/19-6/23 half day PM

6/19-6/23 full day

6/26-6/30 half day AM

6/26-6/30 half day PM

6/26-6/30 full day

7/10-7/14 half day AM

7/10-7/14 half day PM

7/10-7/14 full day

7/17/21 half day AM

7/17/21 half day PM

7/17/21 Full day

7/24/28 half day AM

7/24/28 half day PM

7/24/28 Full day

7/30/AUG 4 half day AM

7/30/AUG 4 half day PM

7/30/AUG 4 Full day

Other:

Required

Option 1

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Have you paid Johnny Tat by Venmo (@johnnyt2050) or Zelle (1-510-909-3558) (both paying and completing this form will reserve and guarantee your spot) ($60/half day, $200/wk for half day, $80/full day, $300/wk for full day) *

Yes, I paid through Zelle

Yes, I paid through Venmo

First Name of Guardian/Emergency Contact *

Last Name of Guardian/Emergency Contact *

Phone Number of Guardian/Emergency Contact *

Are there any needs, accommodations, or information about the participant that would be useful to take into consideration?

By submitting this form and clicking "I agree" below, you hereby agree to waive any injures, claims, and/or liabilities of the participant while attending summer camp and at the ping pong facility. *

I agree

Submit

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