Contact Us

Joshua Wade
(805) 437-2081
cibc@csuci.edu

Parent/Caregiver Information

Please provide the following information on the parent or guardian who will be responsible for this registration. You will be able to register one or more campers on the following pages.

Returning from last year? Save time with our Returning Camper Registration

Required fields are marked with an *

Parent/Caregiver First Name * Parent/Caregiver Last Name * Parent/Caregiver Email * Confirm Parent/Caregiver Email *Please enter your email address again for confirmation Address 1 * Address 2 City * State * ZIP/Postal Code * County *VenturaSanta BarbaraLos AngelesOther Parent/Caregiver Cell Phone * Parent/Caregiver Home Phone Parent/Caregiver Work PhoneInclude extension, if applicable