Child Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

All forms MUST be completed by the Parent or Legal Guardian.
*If enrolling more than one child, please fill out a separate registration form for each child.

Payment is due via Cash, Check, or Credit Card (Paypal) upon submission of this form. Once payment is received in full, you will receive confirmation of your child's registration to Whole Child Nature Camp and you will receive a Parent Handbook and additional required paperwork.

$184/Child if registering by July 1st
$229/Child if registering after July 1st
Cash and Checks may be mailed to ROOTS at PO Box 646, Estes Park, CO 80517

Child's Full Name *

Program Registration *

Whole Child Nature Camp (July 24-28, 2017 / 9am-1pm)

Required

Home Address *

Phone *

Date of Birth *

YYYY

Age *

Other:

Sex *

Male

Female

Prefer not to say

Other:

Child's First Language

Other Spoken Language(s)

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms