Camp Registration

Rainbow Day Camp 2024

"*" indicates required fields

YOUTH PARTICIPATE INFORMATION:

MM slash DD slash YYYY
Please select t-shirt size:*
Teacher of the Visually Impaired (TVI) or O&M Specialist

YOUTH INTERESTS AND SKILL LEVELS:

No experience is necessary.

PARENT/GUARDIAN INFORMATION:

Please list information for parent/guardian with whom the athlete currently resides with.
Preferred address:*
Consent to Participate:*
Medical Consent:*
Photographic Release
MM slash DD slash YYYY

EMERGENCY CONTACT:

If parent/guardian cannot be reached, in case of emergency, contact:
1st Contact Name:*
2nd Contact Name:*