Circus Cascadia Summer Camp Registration Form 2023

Please fill out this form to begin the registration process.
Camp Hours are 10am till 3pm

Please pay full amount to hold your child's spot in the camp.
Please do this right when you finish sending this form to assist easy admin.
Pay using Paypal button on website.

Checks may be sent to:
Circus Cascadia, 8563 SE 257th Ave, Gresham, OR, 97080

You can also email  to arrange payment.

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Email *
Our home Sunshine Creek Farm
Student Name *
Age and Grade level *
What camp are you signing up for? *
Parent or Guardian #1 *
Contact Number for Parent/Guardian *
Email address *
Parent or Guardian #2 *
Contact Number for Parent/Guardian 2 *
Email address for Parent/Guardian 2 *
 Consent for emergency care: I hereby grant permission to Circus Cascadia teachers to perform emergency care, including first aid and CPR on my child and transport my child as deemed necessary for further medical treatment in the event I am unable to be contacted. I further consent to medical or surgical treatment by any licensed physician and or hospital and the administration of surgeries and any other medical treatments deemed necessary or advisable in the event I am unable to be contacted.Electronically signed: *
For Circus Workshop Related Activities.
I give my permission for my child to learn to walk on stilts, unicycle, tightrope, juggle and all other circus arts offered.
I release, hold harmless, and discharge, Circus Cascadia from any liability, claims and causes of action, which may arise.
I understand that Circus Cascadia will, at all times, assist and supervise my child in a safe and supportive manner. 
Please respond with your name and the date, thank you .       
How did you hear about us?
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