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Camper #1 Name: ______________________________
Age: _____ Sex: _____
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Years Playing: _____ Experience
Level: __ beginning __ intermediate __ advanced
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Camp Location: _________________ Camp
Date: ___________ Camp Type:_________________
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Teammate Request: ____________________
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Camper #2 Name: ______________________________
Age: _____ Sex: _____
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Years Playing: _____ Experience
Level: __ beginning __ intermediate __ advanced
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Camp Location: _________________ Camp
Date: ___________ Camp Type:_________________
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Teammate Request: ____________________
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Parent Name: ______________________________
Phone: ( ____ ) _____ - ________
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Email Address: ______________________________
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Address: ____________________________
City: ____________________ State: ___ Zip: ________
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Emergency Contact: ______________________________
Phone: ( ____ ) _____ - ________
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Doctor's Name: _______________________
Phone: ( ____ ) _____ - ________
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Alergies/Medications:
(please indicate for which camper if
more than one child is attending)
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Payment: ( Note:
deposits shall be $50 per player with balance due on
the first day of camp )
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Amount Enclosed: $________
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