2021 Distance Running at YMCA Camp Kresge Registration Form

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Please complete the information below to register for our scholastic running camp. Please note that registration is not considered complete until the $300/runner payment is received. Payment can be remitted by the following options:

Check payable to "Otterbine Distance Running at YMCA Camp Kresge" and mailed to:
Otterbine
11 Lynda Lane
Drums, PA 1822

or

Pay electronically using Venmo to @Tommy-Otterbine

Please direct any questions to Tommy Otterbine (otterbine.tommy@gmail.com / 570-956-5011), Erin Richardson (ejrichardson93@yahoo.com / 570-417-8452), or Lori Wade (loriwade1@gmail.com / 570-956-7338)

Email *

Camper Name *

Street Address *

Please include street, city, state and zip code

Phone Number *

Camper Age (as of 8/1/21) *

Gender Identity *

School Team *

Grade for 2021-22 School Year *

Shirt Size *

Emergency Contact Information

Parent/Guardian Name *

Parent/Guardian Email Address *

Parent Guardian Phone Number *

Payment Options

I will be paying the $300 registration via: *

CHECK (endorsed to "Otterbine Distance Running at YMCA Camp Kresge" and mailed to 11 Lynda Lane; Drums, PA 18222)

VENMO (@Tommy-Otterbine)

A copy of your responses will be emailed to the address you provided.

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