"*" indicates required fields Step 1 of 2 50% Child InformationChild's First Name* Child's Last Name* Child's Date of Birth* Month Day Year Child's 2023-24 Grade*- Select One -Kindergarten (Full in Both)1st Grade (Full in Both)2nd Grade (Full in Both)3rd Grade (Full in Both)4th Grade (Full in Chaska)5th Grade (EP Only)Years Playing Organized Hockey*- Select One -1-23-45-67-8Will your child attend camp in Chaska or Eden Prairie?* Chaska (Full) Eden Prairie Will your child attend camp four or five days a week?* 4 5 Please note any medical conditions or allergies.If any, please explain typical accommodation.Please note any academic, social, or emotional needs.If any, please explain typical accommodation.Please note any scheduled absences.Due to staffing and facility costs, we are not able to pro-rate cost.Please note placement requests.Requests are not guaranteed.Child's Primary Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Child's Secondary Address (If Applicable) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent InformationPrimary Parent First Name*(First contact in case of an emergency) Primary Parent Last Name* Primary Parent Mobile Phone Number*Primary Parent Email* Enter Email Confirm Email Secondary Parent / Contact First Name* Secondary Parent / Contact Last Name* Secondary Parent / Contact Mobile Phone Number*Secondary Parent / Contact Email* Enter Email Confirm Email WaiverClick here to read the waiver.Consent* I acknowledge that I have read and understand the waiver.Full Name*This serves as an electronic signature. Payment* Down Payment - $400 (Remainder due May 19th) Pay in Full - $1600 (4 Days: M-Th Camp) Pay in Full - $1800 (5 Days: M-F Camp) Transaction Fee Price: $0.00 Total Credit CardCard Details Cardholder Name NameThis field is for validation purposes and should be left unchanged. Δ