Register Online

ONLINE APPLICATION FORM

* Indicates required field

Camper Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

School *

Grade *

Age *

Date Of Birth (DD/MM/YYYY) *

Emergency Contact Person *

Emergency Number *

Special Dietary Needs (If Applicable) *

Please Room With (Optional) *

How Did You Hear About Us? *

Consent Disclosure

I submit that my child is physically fit to participate in sports related activities. I recognize there is a risk of injury when playing sports and give my child permission to attend camp. I recognize that I am solely responsible for all payments regarding medical attention. I realize there is a risk of exposure to covid 19 and other biological agents at camp. I hereby release, waive and discharge everyone involved with camp of any loss or damages I hereby authorize the staff of Chase the Game to act according to their best judgement in any situation regarding medical attention. I also give Chase the Game permission to transport the above named camper to use a nearby facility for sports related activities. I also recognize that my child may be taking part in performances and permission is hereby given for the camper to take part in such activities without compensation. The camp may use photographs, statements, and videos of campers in promoting the camp and camp related activities through advertising, websites, publications and exhibitions. A $175 non-refundable deposit is due with application. If you must cancel you must do so in writing before June 1, 2025. Minus a $50 administrative fee if reason is approved. No refunds will be given after June 15, 2025. To consent to disclosure statement, please type "X" in the form field below. *

Parent/Guardian Name *

First

Last

Date of Application Submission (DD/MM/YYYY) *

HOW TO PAY ONLINE

Online payment is accepted through Zelle. Please see instructions below:

Add "New Contact" on Zelle
Select "Business"
For "Business Name," please use: CHASE THE GAME CORP.
Send payment via "Mobile" to: (914) 320-5297
For "Reason," please enter: [CAMPER NAME] - BOYS CAMP 2023
Once complete, you will receive a confirmation number to confirm your payment has been received.

ONLINE REGISTRATION

ONLINE APPLICATION FORM

Consent Disclosure

HOW TO PAY ONLINE

Learn the game at Chase the game

Director

Telephone

Email