Mega Sports Camp 2018

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Name

*

Phone

*

Email

*

This address will receive a confirmation email

Address

*

Name of Spouse and phone number

Names of Child(ren) and Date of Birth

*

#1 Child Sport Pick

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Please select one option.

Basketball Soccer Karate 3-5 years old

#1 Child Shirt Size

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Please select one option.

5T Small Medium Large

Social Media?

*

Please select all that apply.

Yes No

#2 Child Sports Pick

Please select one option.

Basketball Soccer Karate 3-5 years of age

#2 Child Shirt Size

Please select one option.

5T Small Medium Large

Social Media?

Please select all that apply.

Yes No

#3 Child Sports Pick

Please select one option.

Basketball Soccer Karate 3-5 years of age

#3 Child Shirt Size

Please select one option.

5T Samll Medium Large

Social Media?

Please select all that apply.

Yes No

#4 Child Sports Pick

Please select one option.

Basketball Soccer Karate 3-5 years of age

#4 Child Shirt Size

Please select one option.

5T Small Medium Large

Social Media?

Please select all that apply.

Yes No

Notes - Any helpful family information: Allergies, Custody, Questions, etc.

Once your registration is received you will receive an email containing a medical release form. Please fill out and return.
Thank you

How are you paying?

*

Please select one option.

Check Cash Online Interested in Scholarship?

Payment

Scholarship (0) 1 Child ($10) 2 Children ($20) 3 Children ($30) 4 Children ($40)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

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