STRYV365 2025 Fall Camp at West Indy Racquet Club Please fill out a different registration form for each child you are signing up. Question Title * 1. We require one of the following for each camp participant: Copy of birth certificate Copy of state ID card Copy of a student report card Question Title * 2. Parent/Guardian Full Name Question Title * 3. Parent/Guardian Email Address Question Title * 4. Parent/Guardian Telephone Number Question Title * 5. Parent/Guardian Home Address Question Title * 6. Child's Full Name Question Title * 7. Child's Date of Birth (MM/DD/YYYY) Question Title * 8. Child's Grade Level Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Question Title * 9. Emergency Contact Number Question Title * 10. Alternate Emergency Contact Number Question Title * 11. Any medical conditions or allergies we should be aware of? Question Title * 12. Does your child require any special accommodations? Yes No Question Title * 13. If you answered 'Yes' to the previous question, please specify the accommodations needed. Question Title * 14. Besides the parent/guardian listed above, please list alternate individuals allowed to pick-up your child Full Name - Alternate Pick-up Person # 1 Full Name - Alternate Pick-up Person # 2 Question Title * 15. Which session are you interested in? Session 1: September 9th - October 24th ($70) Session 2: October 28th - December 19th ($70) Session 1 & Session 2 ($125) Next