Junior CTA Registration Form 2019
Please fill out separate forms if you are signing up multiple children.
Grades 2- 5
Participant's Last Name
Participant's First Name
Indicate session(s)- $100 for one, $150 for both
Session 1: June 10th - 28th
Session 2: July 8th - 26th
Does your child have any medical conditions that may pose a risk to them at camp? If so, a separate email will be sent to you so we can further discuss your child's needs.
Emergency Contact Information
Parent/Guardian available during camp
Cell Phone Number
Participation and Image Use Waiver
I have read and understand the participation and image use waiver.
By entering your initials on the line below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.
Payment of $100 or $150 will be made via...
How did you hear about CTA?
A friend told me
Summer Camp Open House
How many previous years have you attended Junior CTA?
A copy of your responses will be emailed to the address you provided.
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service