October Track Out Camp Registration Form 2025
Camper's Name
*
First Name
Last Name
Camper's Date of Birth
*
-
Year
-
Month
Day
Camper's Age
*
T-shirt Size (youth)
Please Select
Small
Medium
Large
X-large
Gender
*
Female
Male
Sibling's Name if Attending Camp
First Name
Last Name
Sibling's Birthday
-
Year
-
Month
Day
Date
Sibling Age
Sibling Gender
Female
Male
Other
Date Attending Camp
-
Month
-
Day
Year
Date
Date Attending Camp
-
Month
-
Day
Year
Date
Date Attending Camp
-
Month
-
Day
Year
Date
Parent/Guardian
Parent/Guardian Name
*
First Name
Parent/Guardian Last Name
Parent/Gardian Name
First Name
Parent/Guardian Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Primary Phone Number
*
Parent/Guardian Other Phone Number
Coming with a friend? Please put their names below.
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Medical Information
Does your camper have allergies:
*
Yes
No
Please list allergies:
Please explain on the field provided including any foods to which the camper is allergic. Is your camper allergic to latex?
Medications, both prescription and over the counter drugs can NOT be administered by ANY camp staff. This includes epi pens. You should have listed any allergies above.
*
Please Select
I have read the policy above and understand
We love to take pictures of our campers creating and having fun to share on our social media sites and other studio advertisements. Do we have permission to take pictures of your camper? Pictures are used on marketing materials, social media etc.
*
Please Select
I give permission
I don't give permission
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Contact Information in Case of Emergency
Please enter information for Emergency Contact
Name of Emergency Contact Person
*
First Name
Last Name
Emergency Contact Number
*
-
Area Code
Phone Number
Can they be a pick up for your camper ?
Yes
No
Other people who may pick up your camper.
First Name
Last Name
Alternate Pick Up Phone Number
-
Area Code
Phone Number
HOW DID YOU HEAR OF US?
*
Returning Camper
Referred by a Friend
google
Email Blast from Cheers N Paint
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October 13 - 17th FULL WEEK - PM
$
200.00
Hours 1:00pm - 4:30 pm
Quantity
1
2
3
4
5
6
7
8
9
10
October 13 - 17th FULL WEEK -FULL DAY
$
350.00
Hours 9:00 am - 4:30 pm
Quantity
1
2
3
4
5
6
7
8
9
10
October 13 - 17th FULL WEEK -AM
$
200.00
Hours 9:00 am - 12:30 pm
Quantity
1
2
3
4
5
6
7
8
9
10
October 20 - 24th FULL WEEK -FULL DAY
$
350.00
Hours 9:00 am - 4:30 pm
Quantity
1
2
3
4
5
6
7
8
9
10
October 20 - 24th FULL WEEK - AM
$
200.00
Hours 9:00 am - 12:30 pm
Quantity
1
2
3
4
5
6
7
8
9
10
October 20 - 24th FULL WEEK -PM
$
200.00
Hours 1:00pm - 4:30 pm
Quantity
1
2
3
4
5
6
7
8
9
10
Day Pass- Full Day
$
85.00
Hours 9:00 am - 4:30 pm ( lunch from 12 to 1pm)
Quantity
Oct. 13
1
2
3
4
5
6
7
8
9
10
Oct. 14
1
2
3
4
5
6
7
8
9
10
Oct. 15
1
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5
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9
10
Oct. 16
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5
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8
9
10
Oct. 17
1
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9
10
Oct. 20
1
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9
10
Oct. 21
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9
10
Oct. 22
1
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5
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7
8
9
10
Oct 23
1
2
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4
5
6
7
8
9
10
Oct 24
1
2
3
4
5
6
7
8
9
10
Day Pass- AM Half Day
$
55.00
Hours 9:00 am - 12:30 pm
Quantity
Oct. 13
1
2
3
4
5
6
7
8
9
10
Oct. 14
1
2
3
4
5
6
7
8
9
10
Oct. 15
1
2
3
4
5
6
7
8
9
10
Oct. 16
1
2
3
4
5
6
7
8
9
10
Oct. 17
1
2
3
4
5
6
7
8
9
10
Oct. 20
1
2
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5
6
7
8
9
10
Oct. 21
1
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5
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7
8
9
10
Oct. 22
1
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5
6
7
8
9
10
Oct 23
1
2
3
4
5
6
7
8
9
10
Oct 24
1
2
3
4
5
6
7
8
9
10
Day Pass- PM Half Day
$
55.00
Hours 1:00 pm - 4:30 pm
Quantity
Oct. 13
1
2
3
4
5
6
7
8
9
10
Oct. 14
1
2
3
4
5
6
7
8
9
10
Oct. 15
1
2
3
4
5
6
7
8
9
10
Oct. 16
1
2
3
4
5
6
7
8
9
10
Oct. 17
1
2
3
4
5
6
7
8
9
10
Oct. 20
1
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3
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5
6
7
8
9
10
Oct. 21
1
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5
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8
9
10
Oct. 22
1
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5
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9
10
Oct 23
1
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6
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8
9
10
Oct 24
1
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5
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8
9
10
Total
$
0.00
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