STRYV365 2025 Fall Camp at West Indy Racquet Club

Please fill out a different registration form for each child you are signing up.

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1. We require one of the following for each camp participant: (Required.)

Copy of birth certificate

Copy of state ID card

Copy of a student report card

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2. Parent/Guardian Full Name (Required.)

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3. Parent/Guardian Email Address (Required.)

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4. Parent/Guardian Telephone Number (Required.)

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5. Parent/Guardian Home Address (Required.)

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6. Child's Full Name (Required.)

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7. Child's Date of Birth (MM/DD/YYYY) (Required.)

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8. Child's Grade Level (Required.)

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

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9. Emergency Contact Number (Required.)

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10. Alternate Emergency Contact Number

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11. Any medical conditions or allergies we should be aware of? (Required.)

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12. Does your child require any special accommodations? (Required.)

Yes

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13. If you answered 'Yes' to the previous question, please specify the accommodations needed.

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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

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15. Which session are you interested in? (Required.)

Session 1: September 9th - October 24th ($70)

Session 2: October 28th - December 19th ($70)

Session 1 & Session 2 ($125)

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: (Required.)

Question Title

* 2. Parent/Guardian Full Name (Required.)

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* 3. Parent/Guardian Email Address (Required.)

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* 4. Parent/Guardian Telephone Number (Required.)

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* 5. Parent/Guardian Home Address (Required.)

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* 6. Child's Full Name (Required.)

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* 7. Child's Date of Birth (MM/DD/YYYY) (Required.)

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* 8. Child's Grade Level (Required.)

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* 9. Emergency Contact Number (Required.)

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* 10. Alternate Emergency Contact Number

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* 11. Any medical conditions or allergies we should be aware of? (Required.)

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* 12. Does your child require any special accommodations? (Required.)

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* 13. If you answered 'Yes' to the previous question, please specify the accommodations needed.

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* 14. Besides the parent/guardian listed above, please list alternate individuals allowed to pick-up your child

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* 15. Which session are you interested in? (Required.)

1. We require one of the following for each camp participant: (Required.)

2. Parent/Guardian Full Name (Required.)

3. Parent/Guardian Email Address (Required.)

4. Parent/Guardian Telephone Number (Required.)

5. Parent/Guardian Home Address (Required.)

6. Child's Full Name (Required.)

7. Child's Date of Birth (MM/DD/YYYY) (Required.)

8. Child's Grade Level (Required.)

9. Emergency Contact Number (Required.)

10. Alternate Emergency Contact Number

11. Any medical conditions or allergies we should be aware of? (Required.)

12. Does your child require any special accommodations? (Required.)

13. If you answered 'Yes' to the previous question, please specify the accommodations needed.

14. Besides the parent/guardian listed above, please list alternate individuals allowed to pick-up your child

15. Which session are you interested in? (Required.)