Summer Camp Registration

Registration Form

Please provide the required information below to register your child for Summer Camp.

Child's Information
Child's Name*
First Last
Child's Age*
Sex*
- Male
- Female
Parent/Guardian's Information
Parent/Guardian's Name*
First Last
Address
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Person to contact in case of an emergency
Emergency Contact Name*
First Last
Emergency Contact Address
Street Address Address Line 2 City State ZIP Code
Health Information
Name of child's doctor*
Phone
Hospital Preference
Please list down any allergies or dietary restrictions for your child
Deposit Terms*
- I agree to pay $50.00 non-refundable deposit. This non-refundable deposit includes Caterpillar Clubhouse t-shirt and bag lunch.
Additional Information