CampRegistration - Rustic T Ranch

Please enable JavaScript in your browser to complete this form.

Participant's Name

First

Last

Participant's Age *

Parent's Name *

First

Last

Phone *

Email *

Camp Dates *

Please make sure to check availability before choosing dates.

Authorized Pick Up (1)

First

Last

Authorized Pick Up Phone Number (1)

Authorized Pick Up (2)

First

Last

Authorized Pick Up Phone Number (2)

Emergency Contact *

First

Last

Emergency Contact Phone Number *

Allergies *

Special Needs/ Comments

If needed may we administer over the counter medications as needed

Participant's Approximate Height *

Participant's Approximate Weight *

Will you need extra care outside camp hours? *

Extra care is an additional fee. Please call/text us at 951-897-8612 for pricing and availability.

Signature *

Clear Signature