Coliseum Kid Camp

Cowtown Coliseum

121 E. Exchange Avenue

Fort Worth, Texas  76164

817-625-1025

Coliseum Kid Camp Registration Form:

Complete and drop off in coliseum office or mail this form for each child registering for camp.  A deposit/application fee of $75.00(per week) must accompany this registration form (s) in order for your space to be reserved. The $75.00 deposit/application fee is non-refundable and will be applied to the total amount due for the camp selected below. Make checks payable to: Christy Boner. The remaining camp fee is due 2 weeks prior to 1st day of camp and is refundable up to 72 hours before camp begins. There is a 10% discount for stockyard employees, children of policeman, fireman, nurses, school teachers, military, registering more than 1 child and attending more than 1 week.

Camper's Name___________   ___________   ___________

                                (First)                  (Last)             (Nickname)

Address_______________________________________  Phone___________________

City___________________State_____   Zip__________

Age______ Grade in School________ Height_________ Weight_________

Father's Name___________________ Cell_______________ Work#______________

Mother's Name___________________Cell_______________

Work#_______________

Emergency Contact Name and Phone_____________________________________

Medical or Other Special Needs__________________________

Price is $300.00 per week or $270.00 if discount applies and $240.00 if ex: nurse with 2 children. Check all that apply:

_____June 15th-19th ____June 22nd-26th ____June 29th-July 3rd

_____July 6th-10th    ____July 13th-17th  ______July 20th-24th

_____July 27th- August 1st                        ______August 3rd-7^th