Lisa Sports Hub

Number of Campers

Full Name of Child

Age

Gender

Date of Birth (MM/DD/YYYY)

Home Address (Optional)

Select Weeks (8 Weeks Program)

Week 1July 6 - July 10

Week 2July 13 - July 17

Week 3July 20 - July 24

Week 4July 27 - July 31

Week 5Aug 3 - Aug 7

Week 6Aug 10 - Aug 14

Week 7Aug 17 - Aug 21

Week 8Aug 24 - Aug 28

Amount for this camper

$0

Guardian 1 Name

Guardian 2 Name

Primary Phone

Secondary Phone

Email Address

Contact Name

Relationship

Phone Number