Registration | MelodyFairchild

1089 Laramie Unit #D, Boulder, CO 80302 (303) 818-8063

Name
FirstLast
Email
Enter EmailConfirm Email
Athlete's Cell Phone
Birthday*
Athlete's Address*
Street AddressAddress Line 2CityStateZIP Code
Age at Camp Time*
Grade in the Fall
School attending in the Fall
Father's Name
Father's Cell Phone
Father's Work Phone
Father's place of work
Mother's Name
Mother's Cell Phone
Mother's Work Phone
Mother's place of work
Athlete live with
- Both parents
- Mother
- Father
In addition to those already listed above, two more contacts are required by the State of Colorado Department of Childcare. The following have my permission to sign my child out from the park or camp and may be contacted in an emergency in case I cannot be reached.
Other Contact #1*
Phone
Phone #2
Address Contact #1
Street AddressCityStateZIP Code
Other Contact #2*
Phone #2
Cell Phone #2
Address Contact #2
Street AddressCityStateZIP Code
After completing the Registration, include either:
1) A $250 non-refundable deposit by April 30, 2012. This will be credited to the balance due which must be paid upon check-in, the first day of camp OR
2) Pay FULL amount Make checks payable to: Fairchild Fitness Foundation
Send to:
1089 Laramie Unit #D
Boulder, CO 80304
ARRIVAL: Thursday, June 7, 2012

Please arrive between 1:00-2:00 PM

DEPARTURE: Tuesday, June 12, 2012

Please pick up athletes between 1:00-2:00 PM

Camp Location: 40 Pinecliff Trail, Nederland, CO 80466
SPAM stopper: EZ to do. TX it will help us both

After completing the Registration, include either: