Header image  
Serving the youth of our communities through education, preservation, and recreation

We would like to thank the Port of Los Angeles for their continued support.
 
        HOME     ABOUT US      LEARNING FOR LIFE      CALENDAR      THINGS TO DO      FORMS AND LINKS     FAQS     CONTACT US
 
CLASSES
mm_spacer
 
 

Tiger Cub Day Camp Registration

All fields are required.

Tiger Cub Name:               
Adult Partner Name:
Second Adult Partner ($20 more):
Street Address:    
City:                    State:  Zip Code:
Phone (with area code):     
Email address:   
Pack Number:     Council:

Guardian/Emergency Information
Parent/Guardian Name:       
Home Phone with Area Code:                      
Work/Cell Phone with Area Code:    
 

Emergency Contact Name:    Relationship:
Home Phone with Area Code:                      
Work/Cell Phone with Area Code:    

Does the participant have a history of or currently have any physical limitations that might prevent him/her from fully participating in any classes?  Yes  No
If yes, please describe below.  If none, state "NONE"

Please list any special medications, allergies to food or drugs or any other pertinent medical information.  If none, state "NONE"


 

 
emailSend mail to Webmaster with questions or comments about this web site.
Copyright © 2008-2009 Cabrillo Beach Youth Waterfront Sports Center
Last modified: Saturday, October 10, 2009 10:05 AM