Online Application Instructions

Click Here to fill out the online application and e-mail it to registration.

Remember, if under 18 years of age, your applicant cannot attend the weekend without the signed "Parental Permission" below.

PARENTAL PERMISSION (Applicants under 18 years of age must have a parent's signature) _____________________________________has my permission to attend the North Georgia Chrysalis/YAC weekend #______. In the event of an emergency and if I cannot be reached by phone, the Chrysalis staff has my permission to secure the services of licensed medical professionals to provide the care necessary, including anesthesia, for my child's well-being. We further do hereby release and discharge Chrysalis, its' Board and members from any and all liability from illness, injuries and damages that may arise out of or resulting from my child's participation in or traveling to or from and at this event. Parent/Guardian Signature______________________________ Date_____/_____/________ Phone_______________________

Paypal Instructions Below

You can send the deposit of $25 or full payment for the weekend of $75 via PayPal by adding it to the cart below or send a check with the caterpillar's name in the memo line, made out to North Georgia Chrysalis, to the address below . If you are sponsoring an applicant under 18 years of age, you must print this page, fill it out, have a parent of the applicant sign and date it, and mail it with the deposit/payment to:

Garry and Kerry Smithwick
North Georgia Chrysalis Registration
445 Lula Payne Trail
Ball Ground, GA 30107

(770) 737-4686

Caterpillar Deposit ($25)	Full Caterpillar Fee ($75)	Cart