Week Camp Registration Form
**After submission of this form, we will contact you to arrange payment to complete the registration process**

Holiday Break: 12/26/17 - 12/29/17 (4 Days) $320
Winter Break: 2/19/18 - 2/23/18 (5 Days ) $400
Spring Break: 4/2/18 - 4/6/18 (5 Days ) $400

Monday - Friday
8am - 5pm

(Inquire about early drop off and late pick up)

Sibling Discount - $50 off

ELITE SKILLS Registration Form
Choose Program
Do you need to Drop off your Child before 8am or pick up your child after 5pm? What times? *
Your answer
Parent Information & Contact
First Name *
Your answer
Last Name *
Your answer
Mailing Address *
Your answer
Cell Phone Number *
Your answer
Home Phone Number
Your answer
Email *
Your answer
Youth Information
If registering more than 1 child, please list them from youngest to oldest in each category.
Comma between each multiple child entry. (Ex: John Doe, Jane Doe)
Only siblings may be registered on the same form, no other relation.
Please enter Child's First and Last name.
Date of Birth, only enter numbers (Ex: 1/1/2001)
Gender, only enter first letter (Ex: M or F)
Full Name(s) *
Your answer
Age(s) *
Your answer
Date of Birth(s)
Your answer
Gender(s) *
Your answer
Video / Photography *
Elite Skills has permission to take photos/videos of participants for promotional use.
Required
Medical Release *
My child has been taken to the doctor and has been cleared to participate in physical activity
Required
Emergency Contact
Name *
Your answer
Relationship *
Your answer
Cell Phone *
Your answer
Other Contact Number(s)
Your answer
How did you hear about Elite Skills? *
If you are a return client write "Return"
Your answer
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