POP 2024 CAMP REGISTRATION FORM

POP Youth Leadership Camp is 4-day unique camp with meaningful, fun, & creative activities for boys & girls 8-18 years old from June 24- June 27, 2024 9AM-3PM. Campers will practice and fine-tune peer leadership skills, engage in fun camp games, while working collaboratively to complete a final showcase project. Ages 8-16 may register to attend the camp. Admission is only $25 and covers the camp fee, t-shirt, lunch, snacks, & certificate. Register by May 1, 2024. ARE YOU 17 OR  18 YEARS OLD? DO YOU NEED COMMUNITY SERVICE HOURS? BE A YOUTH CAMP COUNSELOR! For more information about Power of PROGENY Foundation nonprofit, go to powerofprogeny.com.

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First Name Last Name *
Which role are registering for? (To be a youth POP camp counselor, you must be 17 or 18 years old and engage in a virtual interview.) *
Name camper wishes to be called *
Preferred pronouns *
Birthdate (Month, Day, Year) *
MM
/
DD
/
YYYY
Grade *
School *
Camper's t-shirt size *
Name of School *
Please list the (1) name, (2) age, & (3) t-shirt size of the additional camper who will be registered. *
Camper's t-shirt size *
Parent/Guardian's First and Last Name *
Address *
 City, State, Zip code *
Main Phone number
Email of Parent or Guardian *
LIST ONE INDIVIDUAL WHO WE MAY CONTACT IN CASE OF EMERGENCY OTHER THAN THE GUARDIAN LISTED ABOVE: 

FIRST & LAST NAME, 
PHONE NUMBER, 
RELATIONSHIP TO CHILD

We occasionally take photographs or videos to use in future marketing material. We do not include names. Do you permit your child to be photographed and/or videotaped for use by Power of PROGENY Foundation nonprofit? *
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Please note medical conditions, allergies, mobility needs, and/or any other necessary accommodations for each camper.

Please list any medications that need to be administered from 9AM-3PM and the exact dosage.
Please select a payment method for your $25 camp fee FOR EACH REGISTERED CAMPER. Choose your desired payment option.
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