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* 1. Full Name of Participant

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* 2. Parent Name

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* 3. Age of Participant

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* 4. What Grade will the participant be entering in the fall?

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* 5. Parent/Guardian Contact Telephone number

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* 6. Parent/Guardian Contact Email

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* 7. Allergies?  If yes, what are they?

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* 8. By submitting this registration form you are authorizing the Culture Camp staff to take and pictures and or video of participants at camp and during activities.  

Encourage your youth to attend, have a good attitude and participate!  

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