EmailMeForm
Essentials Camp Salt Creek Groupon 2025
Please fill out the below information.
This information is mandatory for enrollment in our program.
YOU MUST BRING A HARD COPY OF YOUR GROUPON VOUCHER WITH REDEMPTION CODE AND CAMP DATES TO THE PROGRAM ON THE FIRST DAY!!
Custom Code from Groupon
(Required and located on your voucher)
*
JG Essentials Camp Salt Creek Beach
Please select the date you purchased below.
ONLY SELECT ONE CAMP:
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Camp Dates
Please select
#1 – June 2 to June 6
#2 – June 9 to June 13
#3 – June 16 to June 20
#4 – June 23 to June 27
#5 – June 30 to July 3 (no July 4th)
#6 – July 7 to July 11
#7 – July 14 to July 18
#8 – July 21 to July 25
#9 – July 28 to August 1
#10 – August 4 to August 8
#11 – August 11 to August 15
PLEASE SELECT ONE CAMP.
If you have purchased more than one camp please fill out this form again. We need one application per camp signup.
Parent's Name
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First
Last
Participant's Name
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First
Last
Date of Birth Format: MM/DD/YYYY
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MM
/
DD
/
YYYY
History of Medical (If none write none)
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Address
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City
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State
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Zip
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Phone
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-
###
-
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Email
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Emergency Contact #1 First Name
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Emergency Contact #1 Last Name
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Phone#
(Differnet from the above phone number. We require 2)
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Emergency Contact #2 First Name
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Emergency Contact #2 Last Name
*
Phone#
*
Please type your full name to agree to our waivers and releases.
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Questions or Comments
