summer camp registration |

summer camp registration

Net Heads Summer Camp 2010 Registration Form

Please complete the following form.

Required entries are marked with a red dot next to them, so don't worry if you can't fill in all the others.

If you are planning to attend multiple camps, please complete multiple registration forms.

Camper Details
Name*
FirstLast
Address*
Street AddressAddress Line 2CityStateZip Code
Email
Cell
Age*
Gender*
Parent Guardian
Name*
FirstLast
Phone*
Cell phone preferred
Work Phone
Additional Phone
Email*
Address
Street AddressAddress Line 2CityStateZip Code
Complete if different from camper's address.
Emergency Contact
Name*
Phone*
Relationship
Camp Selection
We'll do our best to meet everyone's first choice. Selecting alternative weeks allows us to better accommodate everyone. If you are planning to attend multiple camps, please complete multiple registration forms.

NOTE: Our minimum camp size is 8 campers. In the event a class is cancelled, your camper may attend another week or session or receive a full refund. Referral credits are refunded after referral enrolls in a camp.
1st choice week*
1st choice Gamer Camp session*
If your first choice is unavailable
Please select an alternative week in case your first choice is full or in the event less than 8 campers register for your selected week.

If you would like to sign up for additional camps, please complete additional forms.
First choice unavailable session
Second choice unavailable week
Please select a third choice week in case your second choice also becomes unavailable.
Second choice unavailable session
Credits
Save 10% if any one of the above apply.
How did you find us?
How did you find out about our camp?
Referred by
If you were referred by another camper, enter their name here so we will able to give them credit.
Camper Interests and Experience
Game editors used
Favorite games or game types
Attending camp because
Allergies
Does your child have any food allergies, intolerances, or sensitivities? (i.e. peanut, tree nut, dairy, caffeine)
Dietary
Does your child have any dietary concerns? (i.e. vegetarian, no soda/sugar drinks, no energy drinks, no sweets)
Special needs
Does your child have any special needs we should be aware of? (i.e. epilepsy, ADD, wheelchair access)
Other concerns
Any other concerns (medical or otherwise) that we should be aware of?
Content consent*
- I agree
"I understand that Net Heads will attempt to restrict content presented during camp as closely as possible to that represented in the materials presented on its web site. However, content may be subject to change without notice." Our camp cancellation policy is a 100% refund up to two weeks prior to the start of camp.

mon-thu		closed
fri	3p -	1a
sat	11a -	1a
sun	1p -	9p

summer camp registration

Net Heads Summer Camp 2010 Registration Form

Camper Details

Parent Guardian

Emergency Contact

Camp Selection

Camper Interests and Experience