Summer Camp Registration Campers Name (required) Date of birth (required) Gender Male Female Grade 26-27 school year (required) 1 2 3 4 5 6 Parent/ Guardian (required) Relationship to camper (required) Email address (required) Phone (required) Home Address (required) Emergency Contact (required) Phone (required) I understand that this is a community youth organization and my childs photo may be published as a participant in the activities he/she has registered for. I give permission for my child to be transported to activities as scheduled by MPRD. There may be extra registration needed for activities on field trips. Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
