Registration Form: Name: ______

Address: ______

City: ______State: _____

Home Phone: ______

Alternate Phone: ______

Grade entering in Fall 2016: _____

Age: _____ Height: _____ Shirt Size: YM AS AM AL AXL

Parent(s)/Guardian Name: ______

Parent’s work phone: ______

Parent’s cell phone: ______

Camper’s Insurance Co.: ______

Policy #: ______

Address: ______Phone: ______

Parent Signature: ______

Camper Signature: ______