Summer Warrior Camp Registration Form

Before you fill out the form below, please note that registering online does not reserve your spot unless payment of your keiki camp tuition is received within 24 hrs. prior to the first day of camp.

Camper's Name *
Camper's Name
If you are signing up for only a day or a few days of camp, kindly write down the dates you are registering your child. If you are registering for the entire session, you may leave this space blank.
Mother's or Father's Name *
Mother's or Father's Name
Phone *
Phone
Address *
Address
Emergency Contact Name *
Emergency Contact Name
Emergency Contact: Kindly provide the name and number of a trusted individual we may contact in case of an emergency.
Emergency Contact Phone *
Emergency Contact Phone
Please provide any pertinent information regarding health status, developmental progress, and any special needs and efforts necessary to meet those needs in the space below. If none, please leave blank:
Kindly write your first and last name on the space below.