Summer Camp Registration | Capital University
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Summer Camp Registration

  • Camper Information

    Sex:



    First Name


    Last Name


    Middle Initial


    Birth Date
     [None] Select a Date Delete the Date

    Student’s grade next fall:  


    T-shirt size: 

    Home Mailing Address

    Street Address

    City


    State


    Zip Code


    Home phone 
     


    PARENT/LEGAL GUARDIAN INFORMATION

    Parent’s/Legal Guardian’s

    First Name


    Last Name


    Parent’s/Legal Guardian’s email address
     
    (We will use this email to share information about the camp.)

    Daytime Phone


    Home Phone


    Cell Phone


    Camper Pickup: Person who will be picking up the student.


    Name


    Phone


    Relationship to participant


    Do you wish to be put on a waiting list if the program is full?

     

    How did you hear about our camps?



    RELEASE

    I/We, the undersigned, individually and as parent(s) or legal guardian(s) of , , a minor, ask that he/she be admitted to participate in this camp sponsored by Capital University. In consideration of such admission, I/we do hereby agree to release, discharge, and hold harmless Capital University, its officers, agents, and employees of and from all causes, liabilities, damages, claims, or demands whatsoever on account of any injury or accident involving the said minor arising out of the minor’s attendance at the camp or residence in University housing, or in the course of activities held in connection with the camp.

    Signature (At least one is required to complete registration.)
      

    Parent’s/Legal Guardian’s signature Date
     [None] Select a Date Delete the Date

    Enroll the camper in:


    Registration Fee (Please ask about 5% discount for sibling groups, returning campers, or relatives of Capital staff/faculty/students/alums.)  

    QUESTIONS AND COMMENTS: 
      


    Attn: Dr. Sharon Croft
    Department of Communication, Huber-Spielman Hall
    Capital University
    Bexley, OH 43209
    Fax: 614-236-6169
    Phone: 614-236-6338
    Email: scroft2@capital.edu

    By clicking "Submit Form," you are consenting to the terms and conditions on this form. After clicking "submit" you will be led to our secure payment server to complete registration payment.