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First Name *

Last Name *

Gender *

Male Female

Date of Birth * (YYYY-MM-DD)

/ /

Athlete Street Address *

Athlete City *

Athlete Postal Code *

Allergies & medication

Recent injuries

Primary Event Group *

Parent #1 Name (Primary Contact)

Parent #1 Cell Phone - International Number

Parent #1 Email Opt in to emails

Parent #2 Name (optional)

Parent #2 Cell Phone - International Number

Parent #2 Email Opt in to emails

How did you hear about Flying Angels?

Notes or Comments

Name of person completing this form *

Camp Location *

Camp Dates *

Early drop off

$25.00

QTY

Late Pick-up

$25.00

QTY

Flying Angels Summer Camp