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SOTA Kid’s Camp Registration
SOTA Kid’s Camp Registration
Camper Information
Check week you are registering for
*
June 12 – June 16
June 19 – June 23
Campers Name
*
First
Last
Birthdate
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
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10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Food or other allergies/ health concerns
Parent/Guardian
Parent/Guardian Name
*
First
Last
Phone
*
Email
*
Emergency Contact 1
Contact Name
*
First
Last
Phone
*
Emergency Contact 1
Contact Name
*
First
Last
Phone
*
Preferences
With my signature below, I give my preference as to whether my child’s photo/video images can be used for publication purposes by SOTA Studios, Inc. This image can be used in print and on the World Wide Web minus the name.
Photo/video Preference
*
I agree for my child’s photo/video to be used
I do not wish for my child’s photo/video to be used
Liability
Every precaution will be taken for the safety of your camper, however, in the event of accident or injury, my signature below releases SOTA Studio, INC. and SOTA Gallery, Inc. and its staff from any liability.
Please type your first and last name as the signature
*