ClubCorp Network

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Summer Camp Enrollment Form

This form will be submitted to ClubCorp.
Child's Information
Child's First Name:
Child's Last Name:
Address 2:
Postal Code:
How should we contact you ?
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Information Requested
Child's Age
Date of Birth
Parent's Name
Club Member? Yes   No  
Member Number
Youth t-shirt size
Camp Sessions
2016 Camp Sessions
(select all that apply)
 Session l: June 13 - 17
 Session ll: June 20-24
 Session lll: June 27- July 1
 Session lV: July 11-15
 Session V: July 18-22
 Session Vl: July 25-29
 Session Vll: Aug 1 - 5
Within 3 days of enrollment, the Club will send you an e-mail confirmation
and a do follow-up call to secure payment.

Form Verification Code:
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* Bold Fields are Required