CCMI Teen Lodge Form

Step 1 of 4

  • General Information

    This form contains all the information we need to enroll your child in the Teen Lodge. Before you begin please be sure to have the following documents scanned and ready to upload into this form. Make a separate scan for each page of the forms as they will be uploaded separately.
  • 1. Front and back copy of the student's insurance card
  • 2. Completed Health History Form
  • 3. Signed Student Liability Release Form
  • 4. A recent photo of the student clearly showing their face (such as a recent school photo)
  • Make sure this is a recent photo clearly showing the student's face, such as a recent school photo.
    Max. file size: 24 MB.