Camp Jersey Registration - 2023
Registration for all Programs - By registering, I give Jersey Productions permission to photograph, videotape and record my child while attending an educational program sponsored by Jersey Productions.  I also give permission to use, publish and republish my child's image for promotional purposes with or without identification of my child by name.
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Camper's Name *
Date of Birth *
MM
/
DD
/
YYYY
Grade *
(23-24 School Year)
Camper Email
Camper Phone Number
Interested in... *
Required
Gender *
Shirt Size *
Street Address *
City *
State *
Zip Code *
Primary Email *
for correspondence
Parent/Guardian Name *
Parent/Guardian Phone *
Primary Number
Emergency Contact Name/Relationship/Phone Number *
Camper's Physician Name/Phone Number *
Allergies/Medical Concerns *
How did you hear about Camp Jersey Programs *
How will you pay for this session? *
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