Winter Break Camp Registration Form

Choose Week(s) *Week 1: December 26 - 29 ($39)Week 2: January 2 - 9 ($39)Both: Weeks 1 and 2 ($69)

Total Price

$

Athlete First Name *Enter athlete's first name

Athlete Last Name *Enter athlete's last name

Athlete's Age *

Email Address *

Phone *

TPC Waiver

Date of Birth

Select *

Year *0 / 4

Street Address *

Apartment, suite, etc

City *

State *

ZIP Code *

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Phone *

How did you hear about us? *

Waiver*