Registration World Camp 2018

Camp Participant Information
Participants Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth*
MM slash DD slash YYYY
Current Grade Level*
Parent / Guardian Contact Information
Parent Name*
First Last
Parent Email Address*
Email Confirm Email
Will you be traveling with your child?*
- Yes
- No
Parent Cell Phone*
Emergency Contact Name*
First Last
(Other than parent/guardian listed above)
Emergency Contact Phone*
How did you hear about us?*
Arrival Flight Information
Airline*
Flight #*
Departure Airport (leaving from)*
Arrival Airport (flying to)*
Arrival Date*
MM slash DD slash YYYY
Arrival Time*

: Hours

Minutes

AM/PM
Departure Flight Information
Airline*
Flight #*
Departure Airport (leaving from)*
Arrival Airport (flying to)*
Departure Date*
MM slash DD slash YYYY
Departure Time*

: Hours

Minutes

AM/PM
Choosing Payment / Signature
What would you like to pay today?*
After completing this form, you will be redirected to PayPal to complete payment.
Camp Waiver and Agreement*
I have read the above ACKNOWLEDGMENT OF RISKS RELEASE AND INDEMNIFICATION AGREEMENT; by clicking the box below and adding my digital signature, I accept the terms and conditions of this Agreement in its entirety on behalf of the participant being registered on this form. I also attest that I am the parent or legal guardian of the participant being registered, and I have the legal authority to sign this Agreement on their behalf.
- I understand
Signature*

I accept the above ACKNOWLEDGEMENT OF RISKS RELEASE AND INDEMNIFICATION
Would you like to stay connected with the latest information and specials?
- Sure thing!
- No, thank you
Phone
This field is for validation purposes and should be left unchanged.

Camp Participant Information

Parent / Guardian Contact Information

Arrival Flight Information

Departure Flight Information

Choosing Payment / Signature