Camper / Camper Family information

您的浏览器中未启用 JavaScript，因此无法打开此文件。请启用 JavaScript，然后重新加载。

This section asks for general information about the camper and their family.

电子邮件地址 *

Camper First Name *

Camper Last Name *

Camper Likes to be Called *

Date of Birth *

年

月

日

Gender *

Male

Female

其他:

Grade *

School Name *

School District *

Parent/Guardian #1 Name *

Parent/Guardian relation to camper (Mom, Dad, Grandmother, etc.) *

Home Address/Street *

City *

State *

Zip/Postal Code *

Email Address *

Cell Phone *

Home/Other Phone *

Parent/Guardian #2

Parent/Guardian #2 relation to camper (Mom, Dad, Grandmother, etc.)

Home Address / Street for Parent/Guardian #2

City for Parent/Guardian #2

Zip Code for Parent/Guardian #2

Email for Parent/Guardian #2

Cell Phone for Parent/Guardian #2

Home/Other Phone for Parent/Guardian #2

Option 1

清除所选内容

T-Shirt Size *

From whom did you hear about Camp DayDreams? First and Last Name: *

Parent/Guardian Name *

Relationship to Child *

This will be my ___ time attending Camp DayDreams (select one)

10+

清除所选内容

I have siblings/relatives who attend/attended Camp DayDreams. *

Yes

First and Last Names of siblings/relatives who attend/attended Camp DayDreams.

Are you a member of the Boys and Girls Clubs of Rochester? *

Yes

If you are not a member of the BGC (Boys & Girls Club) would you like to become one?

Yes

Maybe

I am already a member of the BGC

清除所选内容

清除表单内容

切勿通过 Google 表单提交密码。

此表单是在 Camp DayDreams 内部创建的。举报滥用行为

表单