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Teen Life Skills Workshop Registration

Parent/Guardian Information

Emergency Contacts

Additional contacts if primary parent/guardian cannot be reached. At least one emergency contact must be listed.

Medical Information

If yes above, click here to download medical form. Upload completed form below.

If answered YES above, please click here to download medical form. Please e-mail completed form to office@loristephensllc.com prior to camp dates.

Notes

How did you hear about us?

Payment

We accept PayPal and all major credit cards. If you do not have a PayPal account or wish to pay with a card, choose "Pay with Debit or Credit."

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