Camp Registration

* Indicates required field
Tuition: $350.00
Camper First Name *
Camper Last Name *
Camper's Preferred Pronouns
Camper Date of Birth *
Parent/Guardian First Name *
Parent/Guardian Last Name *
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 the guardian listed above the social worker on record for the student being registered.
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