Kid's Summer Sports Camp June 17-23, 2019
Please fill out this form and click submit.
Participant's Name
*
Parent/Guardian Name
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Phone
*
Email
*
This address will receive a confirmation email
Participant's Birthday
*
Last Grade Completed
*
Allergies, Medical. Special Needs
Emergency Contact Name
*
Emergency Contact Number
*
Authorized Pick-Up
*
Participant's Name - Child 2
Participant's Birthday
Last Grade Level Completed
Allergies, Medical. Special Needs
Participant's Name - Child 3
Participant's Birthday
Last Grade Level Completed
Allergies, Medical. Special Needs
Participant's Name - Child 4
Participant's Birthday
Last Grade Level Completed
Allergies, Medical. Special Needs
Available Track Options
Desired Track Option
*
Please select one option.
Track 2
Track 4
Track 5
Track 8
Select Option
Track 2
Track 4
Track 5
Track 8
Desired Track Option- Child 2
Please select one option.
Track 2
Track 4
Track 5
Track 8
Select Option
Track 2
Track 4
Track 5
Track 8
Desired Track Option-Child 3
Please select one option.
Track 2
Track 4
Track 5
Track 8
Select Option
Track 2
Track 4
Track 5
Track 8
Desired Track Option- Child 4
Please select one option.
Track 2
Track 4
Track 5
Track 8
Select Option
Track 2
Track 4
Track 5
Track 8
Do you attend church? If so, where?
May we have permission to photograph your child?
*
Submit
Description
Please fill out this form and click submit.
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