Outrageous Extended Registration

Personal Information

First Name*

Last Name*

Address

Address 2

City

State

Zip

Email*

Phone

Summer Camp Registration

The preliminary information we need for your child to come to summer camp. We also require medical forms, which can be downloaded by going to the Summer Camp button and selecting \"Forms.\"

Gender*

Birthday*

Age at camp* Select One 6 7 8 9 10 11 12 13 14 15 16 17 18

# of years as a camper at VK Select One 0 1 2 3 4 5 6 7 8 9 10

T-shirt size Select One YS YM YL S M L XL XXL

Parent Email Address*

Parent #1's Name

Parent 1's Cell #*

Parent 1's Work #

Parent #2

Parent #2 Cell

Parent 2 Work #

Church Name*

Denomination

Church's Town

Mail Forms or Download online?* Select One Mail them I will download them online

Horseback Riding for an additional fee? If so, add stable club registration.* Select One No Beginner(+$130) Intermediate(+$130) Advanced(+$175)

Preferred Roommate?

I give Vanderkamp permission to use photos or videos of my child for promotional purposes.* Select One Yes No