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Funky Divas & Dudes
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First Name
Last Name
Email address *
Password *
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Parent 1 Name *Please put the CHILD'S name in the FIRST NAME & LAST NAME area above. This way it is your child's name that shows up on our rosters.
Cell Phone
Parent 2 Name
Home Phone
Grade
Date of Birth
Gender
School
Address
City
Postal\Zip Code
Emergency Contact (& Relationship)
Emergency Contact Phone #
List any allergies, medications, health concerns, or previous injuries
I give permission for my child to go in to the water at Santa Monica beach. (CAMP QUESTION ONLY. ALL OTHERS FILL IN N/A)
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