Camp Registration

* Indicates required field
 
Tuition: $350.00
 
Camper First Name *
Camper Last Name *
Camper's Preferred Pronouns
Camper Date of Birth *
Legal Parent/Guardian First Name *
Legal Parent/Guardian Last Name *
Legal Parent/Guardian Email *

*Please enter an email address that is actively monitored. The email address entered will be used to set up your account and will receive all communications about account billing and camp details.

Please indicate if you are the child's legal parent, guardian, or a social services representative.
Is Parent/Guardian a Central Piedmont Employee? *
Address *
City *
State *
Zip *
School Attending *
School Type *
If Other, please specify
Upcoming Grade *
Phone *
T-Shirt Size Preference (Adult Sizes S-XL) *
Emergency Contact Name *
Emergency Contact Phone *
How did you hear about us? *
Promotional Code