2019 Distance Running at YMCA Camp Kresge Registration Form
Please complete the information below to register for our scholastic running camp. Please note that registration is not considered complete until the $285/runner payment is received. Payment can be remitted by the following options:

Check payable to "Otterbine Distance Running at YMCA Camp Kresge" and mailed to:
11 Lynda Lane
Drums, PA 1822


Pay electronically using Venmo to @Tommy-Otterbine

Please direct any questions to Tommy Otterbine (otterbine.tommy@gmail.com / 570-956-5011), Erin Richardson (ejrichardson93@yahoo.com / 570-417-8452), or Lori Wade (loriwade1@gmail.com / 570-956-7338)

Email address *
Camper Name *
Your answer
Street Address *
Please include street, city, state and zip code
Your answer
Phone Number *
Your answer
Camper Age (as of 7/27/19) *
Your answer
Gender Identity *
School Team *
Your answer
Grade for 2019-20 School Year *
Shirt Size *
Emergency Contact Information
Parent/Guardian Name *
Your answer
Parent/Guardian Email Address *
Your answer
Parent Guardian Phone Number *
Your answer
Payment Options
I will be paying the $285 registration via: *
A copy of your responses will be emailed to the address you provided.
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