Distance Running Camp - Team Discount Form

In order to receive the team discount, you must list five or more team members attending the Luther College Distance Running Camp.

If someone you have listed does not attend, $35 will be added to your balance due at check-in.

* = required field

NOTE: Campers MUST have proof of health insurance (copy of insurance card) provided to Luther college before check-in in order to participate in our camps.
Team Member 1 (your name)*
Team Member 2*
Team Member 3*
Team Member 4*
Team Member 5*
Additional team members
___________________________________________________
First Name
Last Name*
Grade next fall*
School*
Gender*
Age*
Birth date*
/ /
Home address*
City*
State*
Zip code*
Home phone
Parent's cell phone
Camper's cell phone
Camper's e-mail
Preferred roommate
Parent's e-mail*
Preferred roommate (one name only)
Adult T-shirt Size*
Refund Policy: Written or e-mailed cancellation notice that is received five or more business days prior to the first day of camp will result in a full refund, less a $50 cancellation fee.
Attending as*
Payment Amount*
Payment Method
Credit Card Type*
Credit Card Number*
Expiration Month*
Expiration Year*
Name as it appears on card*
Billing Street Address*
Billing City*
Billing State/Province*
Billing Zip/Postal Code*
Billing Country