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Skills & Drill Registration Form

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Camper Full Name *

Date of Birth *

Gender *

School *

Grade Level *

Shirt Size *

Any known allergies? *

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List allergies

Medical Insurance? *

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Primary Physician

Parent Full Name *

Phone *

Email *

Add Contact? *

Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in the case of an emergency.

Relationship *

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Sibling
Relative

Any Insurance? Birth

Name *

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Last

Phone *

Questions or Comments

Are you looking to pickup volunteer hours?

Become a Volunteer for Zuri’s Circle

Up to 70% of college admissions officers in the US confess that volunteering is one of the things that grab their attention.

“I think I have learned that the best way to lift one’s self up is to help someone else.”

~Booker T Washington

Services

Homeless Outreach

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Contact

Peoria, Arizona

info@zuriscircle.org

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