Cedar Glade Youth Camp Registration

Please fill out the form in all the applicable areas. Many areas are required fields. Your registration will not be complete until each required field has been filled in. Each participant must fill out the form separately. If you have two participants, you must register them separately.

Student Name *
Student Name
Gender *
Age *
Child's Birth Date *
Child's Birth Date
Grade Completed *
Choose 3 Different Rotations
There are 10 rotations to choose from. You may pick 3 different rotations. If you choose less than 3, we will choose for you. If you choose the same rotation twice or three times, we will choose for you. Please make sure all your choices are different.