Beat Boppers 2024 K:P Summer Camp
Please use this form to register for our 2024 Beat Boppers Summer Camp.  Following registration you will see an on screen message confirming your submission of this form.  To receive a confirmation email/copy of your responses, you must select the option requesting one on the form.  Within 2 business days you will receive an invoice through ProCare for the camp registration fee.  Additional camp specific information about drop offs, pick ups, etc. will follow in an email closer to the start of your camp week.  Please email our camp director, Vanessa, with any questions: vgravell@kinpathic.com
Sign in to Google to save your progress. Learn more
Email *
How did you hear about us? *
Camper Last Name *
Camper First Name *
Camper Age *
Camper DOB *
MM
/
DD
/
YYYY
Camper Home Address *
Please list any allergies or sensitivities (food or other):
Please list any pertinent medical conditions, that camp counselors should be aware of
Is there any other information you would like us to know about your camper, or any accommodations they might need?
Parent/Guardian 1 First & Last Name *
Parent/Guardian 1 Phone Number *
Parent/Guardian 1 Email *
Parent/Guardian 2 First & Last Name
Parent/Guardian 2 Phone Number
Parent/Guardian 2 Email
Emergency Contact and Authorized Pick Up Person 1 First & Last Name (Must bring a valid photo ID to pick up the camper) *
Emergency Contact and Authorized Pick Up Person 1 Phone Number
 *
Emergency Contact and Authorized Pick Up Person 2 First & Last Name
Emergency Contact and Authorized Pick Up Person 2 Phone Number
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Breakthrough Behavioral and Educational Consultants. Report Abuse
Google Forms