Orinda Park, Inc. Online Registration

Registration

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Welcome to Orinda Park Pool Kids Camp Registration. Please follow the steps and provide the information requested below.

* denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address

City

State

Zip

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)

Health Insurance Carrier

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Once you've entered all the required information for your camper above, click "search" next to "Select Class #1" to see available classes.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Once you've entered all the required information for your camper above, click "search" next to "Select Class #1" to see available classes.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Once you've entered all the required information for your camper above, click "search" next to "Select Class #1" to see available classes.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Once you've entered all the required information for your camper above, click "search" next to "Select Class #1" to see available classes.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Once you've entered all the required information for your camper above, click "search" next to "Select Class #1" to see available classes.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*