Camp Registration Form

Please fill out this form completely to register for the camp.

Participant Information

Name

    Date of Birth

      Address

        Phone number

          Email

            Emergency Contact Information

            Name

              Relationship

                Phone number

                  Alternate Phone number

                    Camp Details

                    Camp Name

                      Session Dates

                      From

                        To

                          Preferred Activities

                          Check all that apply.

                            • Hiking

                            • Swimming

                            • Arts & Crafts

                            • Team Sports

                            • Nature Exploration

                            Medical Information

                            Allergies or Medical Conditions

                              Medications

                                Primary Physician

                                  Physician Phone number

                                    Parental/Guardian Consent

                                    I consent to the above-mentioned participant attending and participating in the camp activities. I acknowledge that I have provided accurate information to the best of my knowledge.

                                    Name:

                                    Date:

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