2023 Diesel Camp - CCC Sign-up Form

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Student First Name

Student Last Name

Guardian First Name

Guardian Last Name

Guardian Phone

City, State

Guardian Email Address

Zip Code

Students shirt size (adult unisex fit):

Students grade as of Fall 2023:

9th Grade

10th Grade

Student intends to take advantage of the on-campus housing

Yes, please

No, thank you

Does this student have any dietary restrictions?

Yes

Please list dietary restrictions below

Will you need registration cost assistance:

Yes, please!

I understand and agree that by checking the box below I consent that photos & videos taken of my child during this event may be used for future Titan Machinery or Central Community College marketing purposes.

I understand & agree

Questions or Comments?

^{By clicking the Register button below, I agree that participation in the Diesel Camp may result in injury, however unlikely, and release Titan Machinery Inc. and}^{Central Community College from all liability, costs, and damages.}

New Equipment

Equipment Search

Offers & Promotions

Equipment Parts

Equipment Service

Precision & Machine Control

About Us

^{By clicking the Register button below, I agree that participation in the Diesel Camp may result in injury, however unlikely, and release Titan Machinery Inc. and}^{Central Community College from all liability, costs, and damages.}

New Equipment

Equipment Search

Offers & Promotions

Equipment Parts

Equipment Service

Precision & Machine Control

About Us

By clicking the Register button below, I agree that participation in the Diesel Camp may result in injury, however unlikely, and release Titan Machinery Inc. andCentral Community College from all liability, costs, and damages.

^{By clicking the Register button below, I agree that participation in the Diesel Camp may result in injury, however unlikely, and release Titan Machinery Inc. and}^{Central Community College from all liability, costs, and damages.}