CYC Summer Camp Registration
Please complete the registration form to reserve your child's spot for camp and submit the non-refundable registration fee.
Camper's Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Does the camper have any allergies or medical conditions?
*
What session(s) are you registering for?
*
Session 1 June 22 - July 3
Session 2 July 6 - July 17
Session 3 July 20 - July 31
Registration Fee
*
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Registration Fee
One time non-refundable registration fee
$25.00
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Register
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