Online Registration Form
Download a medical consent form here. Don't forget to have it notarized!!!!
Child's Name:
Complete Street Address or PO Box:
City:
State:
Zip Code:
Grade Just Completed (Only grades 5-8):
Gender (Male or Female):
Age:
Food Allergies:
Medical Conditions/Physical Restrictions:
Is Child Bringing Medications with him/her?:
Name of Legal Guardian:
Mobile Number:
Home Number:
Work Number:
E-Mail:
Name of Afternoon Pick-up Person:
Mobile Number of Pick-up Person:
I am aware that there are only 60 spots available for YOU 2011 on a first-come-first-served basis
:
Yes
I understand that my child must be COMPLETELY REGISTERED to reserve one of those spots
:
Yes
I understand that for my child to be COMPLETELY REGISTERED, I must send or hand deliver (no faxed copies) the following three forms: (1) Online Registration, (2) notarized Medical Consent Form, (3) Rock Climbing Waiver.
Yes
I understand that I must complete the
Rock Climbing Waiver
in blue or black ink.
Yes
Comments: