2017 Summer Camp Registration
Please fill this form out to register your child(ren) for 5 Elements' 2017 Summer Camp. Please note that registration without payment is not valid and will be voided in our system. Thank you for signing up!
How did you first hear about the spring camp? *
Which camp(s) are you registering for? *
Required
First Child
Child's Name *
Your answer
Gender *
Age *
My child currently attends 5 Elements Martial Arts *
Second Child (if applicable)
Child's Name
Your answer
Gender
Age
My child currently attends 5 Elements Martial Arts
Contact Information
Parent/Guardian Name *
Your answer
Home Address *
Your answer
Home or Work Phone *
Your answer
Cell Phone *
Your answer
Email Address *
Your answer
Additional Contact Information
Please include any other relevant information whether an alternative guardian (with contact info) for pickup or another way to get in touch with you.
Your answer
Terms and Conditions
Terms and Conditions: http://goo.gl/SjdKzb *
Required
Payment must be made before your reservation is complete. *
I understand that I must submit my payment for this camp to finalize my reservation. Completing this registration form without payment will NOT guarantee that a place will be held.
Required
Additional Comments
(If you have more than 2 siblings or special circumstances, you can mention them here.)
Your answer
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