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. Each member of the team needs to fill out and submit this form. If someone you have listed does not attend, $35 will be added to your balance due at check-in. This discount cannot be used in combination with the "Family Discount".

* = required field

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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 (MM/DD/YYYY)*
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 Information

Name as it appears on card*
Billing Street Address*
City*
State/Province*
Zip/Postal Code*
Country*
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