Form Designer

Summer Camp Registration

No substitutions for packages please.

Member Number/Sponsor's Member Number *

Child's First Name *

Child's Last Name *

Click here if child is a non-Member

Phone Number *

Secondary Phone Number *

Parent/Guardian Full Name *

Parent/Guardian Email Address *

Please list the first and last names of up to four people that you give permission to be an authorized pick-up person: *

Child's Birthdate *

My child is... *

Rising 4th-6th Grade

Rising K-3rd Grade

Male or Female *

Female

Male

Does your child have any special dietary consideration? *

Please list any allergies, diseases, or medical problems we should be aware of.

No substitutions for packages please.

My child is...

an independent swimmer

in need of floaties

No substitutions for packages please.

By checking this box, I hearby acknowledge that I have read the Cancellation Policy, Release Form, Camp Procedures & Policies, and I understand and agree to the terms releasing claims and legal rights. *

Your Name *

Your Email Address *

* Denotes Required Field

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