Choose what camp you would like to attend this summer! All camps will run from July 8-12 from 8:30am-12:30pm. Please see the 2024 Summer Camp Flyer for specifics on each camp. *
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Student First Name *
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Student Last Name *
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Student Street Address *
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Student City, State and Zip *
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Date of Birth *
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Age as of 7/1/2024 *
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In fall of 2024, what grade will you be entering? *
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What School do you attend? *
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Student home phone *
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T-shirt size (adult sized shirts)
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Contact 1-First Name *
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Contact 1-Last Name *
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Contact 1-Relationship to student *
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Contact 1-Home Phone *
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Contact 1-Cell Phone *
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Contact 1-Work Phone
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Contact 1-Employer
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Contact 1-Email Address *
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Contact 1-Full Physical Address *
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Contact 2-First Name *
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Contact 2-Last Name *
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Contact 2-Relationship to student *
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Contact 2-Home Phone *
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Contact 2-Cell Phone *
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Contact 2-Work Phone
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Contact 2-Employer
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Contact 2-Email Address *
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Contact 2-Full Physical Address *
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Who does the child live with? *
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Please list who is allowed to pick this student up from camp: *
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