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Kids Summer Camp Registration Form
Mission assignment will be received upon completion of registration

CAMP TIMES: Monday - Thursday
  Early
Reg.   
After
May 1st
Programs
$ 95
$115
June 7th - June 17th (2 weeks)
$ 95
$115
June 21st - July 1st (2 weeks)
$ 95
$115
July 5th - July 15th (2 weeks)
$ 95
$115
July 19th - July 29th (2 weeks)
$180
$200
June 7th - July 1st (4 weeks)
$270
$290
June 7th - July 15th (6 weeks)
$360
$380
June 7th - July 29th (8 weeks)
Your Information
First Name
Last Name
Date of Birth
Age
Address
City
State
Zip
Parent's Name
Home
Work
Mobile
Telephone
Email
School Name
School District
Grade
Emergency Contact Name
Emergency Contact Number
Current Fitness Level
Activity Level
Organized Sports
(list sports or activities in school or community center)
T-shirt size (adult sizes)
  
Please answer the following questions:
YES
NO
 
Has your doctor ever said you have heart trouble?
Have you ever had pains in your chest?
Do you often feel faint or have spells of dizziness?
Has a doctor said your blood pressure is too high?
Has a doctor said that you might have bone or joint problems, such as arthritis, that has been aggravated by exercise/ worse with exercise?
Have you been hospitalized in the past 3 years?
Are you currently taking medication?
Do you suffer from asthma or breathing difficulties?
Do you suffer from diabetes or epilepsy?
Do you suffer from an allergy?
If 'Yes' what medication do you take?
Is there any physical/medical reason not mentioned here why you should not follow an exercise program?
Where did you hear about us?
*If you answered 'Yes' to one or more of these questions, please consult you physician before starting any exercise program.

Comments or additional information


If you would rather mail your registration,
download the form here.