Breaker Rock Beach Kids Camp

Volunteer Registration

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Participant Registration
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Printable Form

If you or your child would like to participate in this event as a Volunteer, please complete the following form.

(If you are under 18, please have your parent or guardian complete the form.)

Personal Information

*First Name:
*Last Name:
*Cell Phone:
*Email:
*Address:
*City:
*State:
*Zip:
*Birthday: (MM/DD/YYYY)
*T-Shirt Size:
*Are there any days you will be late or out?: (Abbreviate M, T, W, TH, F and LATE or OUT)
*Volunteer Position (1st Choice):
*Volunteer Position (2nd Choice):
*Allergies/Medical Conditions: (i.e. Peanuts, Uses Inhaler etc.)