Please fill out the form to register for class First Campers Name Age of Student Date of Birth Second Campers Name Age of Student Date of Birth Third Campers Name Age of Student Date of Birth Parent or Guardian Name Parent or Guardian Email Parent or Guardian Phone Number Parent or Guardian Home Address Second Parent or Guardian Name Second Parent or Guardian Phone Number Please List Any Medical Conditions, Food Allergies or Disabilities That May Affect Your Child in a Classroom Setting. We do not discriminate, in fact we welcome many students with disabilities. We need to know so that we can prepare. Physicians Name Physicians Contact Phone Number Emergency Contact Other than Spouse or Guardian Emergency Contact Phone Number Send
