2017 NRGYF & RoboJackets K-8 Camp Registration
Youth Information
Youth Last Name *
Your answer
Youth First Name *
Your answer
Grade *
2017-2018 School Year
School *
2017-2018 School Year
Other Pertinent Information
Allergies, medical conditions, anything else you feel we ought to know
Your answer
Camp Sections
Camp Sections *
M-F Full Day ($250)
M-F AM Only ($150)
W-Th Full Day ($150)
W-Th AM Only ($75)
None
Session 2: Aug 7-Aug 11
Session 3: Aug 14-Aug 18
Session 4: Aug 21-Aug 25
Session 5: Aug 28-Sep 31 (4 Day Week)
Household & Parent/Guardian Information
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Parent/Adult #1 Name *
Your answer
Parent/Adult #1 Email *
Your answer
Parent/Adult #1 Relation *
Relation to child.
Your answer
Parent/Adult #1 Phone *
Preferably cell number. If that's not an option, whichever is most likely to be answered.
Your answer
Adult #2 Name *
Your answer
Adult #2 Relation *
Relation to child. May be other parent, or any other adult who can serve as second point of contact if the need arises.
Your answer
Adult #2 Email *
Your answer
Adult #2 Phone *
Preferably cell number. If that's not an option, whichever is most likely to be answered.
Your answer
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