Road and Dirt

Kids Bike Camp

Summer 2014
Registration Form

Camp Dates (check all attending):

June 9 13
July 21 - 25
Time 9:00 AM 1:00 PM
Name of Child: _________________________________________________________________
Age: __________

Gender: ___________

Name of Parent: ________________________________________________________________

Parent Cell Phone: ______________________________________________________________
Contact in case of emergency: _____________________________________________________
Cell Number: ___________________________________________________________________
Camp Location: Croy Canyon BMX Park 3.5 Miles West of Hailey on Croy
Lunch is included in camp fee. Please indicate if your child is allergic to any foods.
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Camp Fee: one session is $275 per week (lunch included) or $500 for two weeks
Non-refundable Camp deposit of $50 is required.
Makes checks Payable to Road and Dirt (either mail check or drop off at the Powerhouse on
Main Street in Hailey): 411 Main Street Hailey, Idaho 83333
Contact the Coach, Joel Zellers: 208-309-1119 or at svroaddirt@gmail.com subject line:
RD Camp