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The Journey Sports Camp

Fill out the form below to register and reserve your place for the Journey Sports Camp: 2008. Please note that your registration will not be complete until you sign a release form. By completing this form you are simply reserving a spot for your child.

If you have any questions or require further assistance please call The Journey offices at 610-344-9332.

     Parent Information
Father's First Name    Cell Phone
Mother's First Name    Cell Phone
Last Name   
Address   
City   
State   
Zip   
Telephone   
Email   
Emergency Contact    Telephone
Insurance Company    Policy Number
How did you hear
about Sports Camp?		   At The Journey Word of mouth Yard sign Newspaper
   
     Child Information
Child's Name  
Child's Current Grade Age
 

Does this child have any disabilities, handicaps, present injuries/limitations, allergies, hemophilia, heart condition, history of respiratory illness or any other significant medical conditions?
Yes    No

If yes, please explain:
    

 

 
 
 

200 South Church Street West Chester, PA 19382
610-344-9332     map
(c) Copyright 2007 The Journey West Chester