EmailMeForm
Youth Camp
June 24th-27th • 6th-12th grade
$100 deposit non refundable due April 7th
$280 student total cost due by May 26th
Camp Location:5241 FM 66 Waxahachie TX
Please list PARENT info first along with the best contact information. Parents will be added into a GroupMe and there is where ALL information will be communicated about CAMP.
Parent/Guardian Name
First
Last
Phone
###
-
###
-
####
Email
EMERGENCY CONTACT (If Parent/Guardian can't be reached)
First
Last
Phone
###
-
###
-
####
Student Info
Student Name
First
Last
Date of Birth
MM
/
DD
/
YYYY
Gender
Please select
Male
Female
Grade
Please select
6th
7th
8th
9th
10th
11th
12th
MEDICAL INFORMATION
Please list any Chronic/Recurring Conditions or Special Needs, along with any other information you'd like us to know
Do you have any dietary restrictions that require an individual meal?
None
Dairy Free
Gluten Free
Peanut Free
Please list any additional allergies to food or medications
