Summer Camp Registration - Hillcrest Ravens

Student Name*
First Last
Address*
Street Address City State ZIP Code
Sex*
- Female
- Male
Date of Birth*
MM slash DD slash YYYY
Grade in 2023-24 school year*
School attending in 2023-24*
Parent/Guardian Information
Parent/Guardian Name*
First Last
Parent/Guardian Address is same as above*
- Yes
- No
Parent/Guardian Address*
Street Address City State / Province / Region ZIP / Postal Code
Parent/Guardian Cell Phone*
Parent/Guardian Email*
Emergency Contact Person (other than Parent/Guardian listed above)*
Emergency Contact Person Cell Phone Number*

Parent/Guardian Information