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B&B Climbing Camp Registration Form
If you have any questions or concerns, please email us at bouldersandbrewsgym@gmail.com.
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* Indicates required question
Camper's Name:
*
Your answer
Camper's
Age:
*
Your answer
Parent/Guardian's Name:
*
Your answer
Email:
*
Your answer
Phone Number:
*
Your answer
Emergency Contact Name (skip if same as parent/guardian):
Your answer
Emergency Contact Phone Number:
Your answer
Which week do you want to register your camper for?
*
June 10 (Mon) - June 13 (Thurs) @ 9am-1pm
June 17 (Mon) - June 20 (Thurs) @ 9am-1pm
June 24 (Mon) - June 27 (Thurs) @ 9am-1pm
Required
Does your child have any allergies or medical conditions that we should be aware of?
*
Your answer
Does your child have any special needs or accommodations that we should be aware of?
*
Your answer
Does your child have any climbing experience? (select one)
*
Yes, my child has climbed before
No, my child has never climbed before
Is there anything else that you would like us to know about your child?
Your answer
Name of Referrer (For each new camper that signs up and mentions your name as the referrer, you will receive a $20 discount on your child's camp fees. The more friends you refer, the more you can save!
)
Your answer
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