Summer Camp Sign up 2019
* Pre-registration is required at least 3 days before the first date of camp, unless otherwise noted.
*You will be notified by phone only if camp is cancelled.
*As always, we accept your completed registration form by mail, online, email or in person at our campus.
*Please use EZ pay to pay for camps
*Please use a separate for for each child
Email address *
Camper's First Name *
Your answer
Camper's Last Name *
Your answer
Gender *
Address - Street *
Your answer
Address - City *
Your answer
Address - ZIP *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Grade for 2019-2020 School Year *
Camper's T-Shirt Size *
Parent/Guardian Name *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Phone *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Relationship *
Your answer
Emergency Contact Phone *
Your answer
Special Concerns (Medical etc...)
Your answer
Camp *
Required
We/I agree to release, indemnify and hold harmless Coal City High School, its agents, trustees, employees, representative or assigns, including the coaching and training staff and camp employees, from all claims resulting from any injury sustained by my child while in the camp. We/I further hereby give permission to the coaches, training staff or other medical professionals to provide medical care as deemed necessary to my child in case of injury or illness. *
Required
Parent Signature *
Your answer
A copy of your responses will be emailed to the address you provided.
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