camp registration form

SKATEBOARD CAMP REGISTRATION FORM

NAME / AGE:

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ADDRESS / CITY / ZIP CODE:

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EMAIL ADDRESS:

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PARENT'S NAME AND WORK # :

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PARENT'S NAME AND WORK # :

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CELL #(S)

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HOME #(S):

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Please prioritize numbers for emergency purposes
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SPRING BREAK CAMP -
March 29th - April 2nd
180.00 for complete package -
includes lunch
Or: 40.00 per day
Lunch: 4.00 per day
AMOUNT ENCLOSED: _____________________
Payment in full required to reserve your placement in camp.

Mail check and this form to:

3rd Lair 850 Florida Ave.
Golden Valley, Mn.
55426

For more information contact:

mark@3rdlair.com

or call:

763 797 7401 to sign up with credit card