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Four Cs Summer Camp Registration
Please complete the following registration information.
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* Indicates required question
Name
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Address
*
Your answer
City
*
Your answer
Zip
*
Your answer
Grade Level for Next School Year (2019-2020)
*
6
7
8
Will you need transportation to participate in camp?
*
Yes
No
Parent/Guardian Name (Emergency Contact)
*
Your answer
Parent/Guardian Phone 1 (Emergency Contact)
*
Your answer
Parent/Guardian Phone 2 (Emergency Contact)
Your answer
Parent/Guardian Phone 3 (Emergency Contact)
Your answer
Parent/Guardian Email
Your answer
Important Medical Information
Your answer
Photos are an important part of modern experiences. I understand that my student may appear in photos taken at the Four Cs Summer Camp and may be used or distributed by the staff for current or future publications.
*
Yes, I agree
I would like to speak with a staff member before answering.
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