Irish Cultural Camp Registration


Child 1

Child 1 Name:*
Child 1 Allergies/Needs (Enter "none" if none):*
Child 1 Age:*
Child 1 Shirt Size:*
Child 1 Interests (Select 4):*

Child 2

Child 2 Name:
Child 2 Allergies/Needs (Enter "none" if none):
Child 2 Age:
Child 2 Shirt Size:
Child 2 Interests (Select 4):

Child 3

Child 3 Name:
Child 3 Allergies/Needs (Enter "none" if none):
Child 3 Age:
Child 3 Shirt Size:
Child 3 Interests (Select 4):

Child 4

Child 4 Name:
Child 4 Allergies/Needs (Enter "none" if none):
Child 4 Age:
Child 4 Shirt Size:
Child 4 Interests (Select 4):
Contact Details
Emergency Contact:*
Emergency E-mail:*
Emergency Phone:*
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Registration Fees: All Credit Cards Accepted
Select Amount from DropDown:*
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