Summer 2023 Youth DnD Camp Registration – Carlisle

DnD Camp Registration 2023

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Participant Name(Required)

First Middle Last

Gender

Age(Required)

Grade(Required)

School(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Caregiver/Guardian Name(Required)

First Middle Last

Caregiver Email

Home Phone(Required)

Cell Phone

Work Phone

Emergency Contact Information

If you cannot be reached, please provide two names of local persons to contact in case of emergency.

Name(Required)

First Last

Relationship to Participant(Required)

Phone(Required)

Name(Required)

First Last

Relationship to Participant(Required)

Phone(Required)

Allergies/Other Medical Conditions

D&D Summer Camp Registration (Required)

Price: $150.00

Total

Credit Card(Required)

Cardholder Name

Card Details

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