IS El Dorado Holiday Camp 2019

Camper Name*

Gender*

Male
Female

Date of Birth*

Parent Name*

Parent Email*

Primary Phone Number*

Address*

Emergency Contact Name During Camp Hours*

Emergency Contact Phone Number*

Are there any medical issues we should be aware of?*

Yes
No

Have you been to one of our camps before?*

Yes
No

How Did You Hear About Our Camp?*

Google or other search engines
Facebook
Email
Yelp
Friend or Family Referral
Club Advertisement (flyer, poster etc)
Activity Hero
www.cliffdrysdale.com
Club website
Other

Are you an In-Shape member?*

Yes
No

Choose Your Camp Session Dates*

Full Session
December 23, 26, 27, 30 & January 2
Price $140.00
Attend This Session
By the Day - December 23
Price $45.00
Attend This Session
By the Day - December 26
Price $45.00
Attend This Session
By the Day - December 27
Price $45.00
Attend This Session
By the Day - December 30
Price $45.00
Attend This Session
By the Day - January 2
Price $45.00
Attend This Session

Convenience Fee

$1.00

Running Total

$1.00

Coupon Code

Total

$1.00

Terms and Conditions*

Liability Disclaimer: In consideration of Cliff Drysdale Management, Allowing my child's/children's participation in the camp, I for myself and my child/Children release Cliff Drysdale Management and its partners and affiliated officers, directors, agents and employees from and waive all claims, damages, and liabilities what soever for property damage or loss, personal injury or death arising from or in connection with my child's/children's participation in the camp. Cliff Drysdale Management retains all rights to any video and photographs taken at the camp to be used for publicity or advertising.

I, the undersigned, agree to the terms above.

Billing Information

Name*

Credit Card*

Visa
Mastercard
American Express
Discover

Address*

Email*

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