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Hamm Camp 2019: Ages 13-17 Signup Form
Hamm Camp is FREE for Harrisburg residents.
Camp Dates: - July 22-26, 2019
To register, please fill out the form below. We look forward to seeing you at camp! (10am-3pm)
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* Indicates required question
Email
*
Your email
Camper First Name
*
Your answer
Camper Last Name
*
Your answer
Camper Gender
*
Male
Female
Harrisburg Resident?
*
Yes
No
Camper Street Address
*
Your answer
Camper City
*
Your answer
Camper State
*
Choose
PA
NJ
MD
NY
Camper Zip Code
*
Your answer
Camper Age
*
Your answer
Camper Birthday
*
MM
/
DD
/
YYYY
Camper School
*
Your answer
Camper T-Shirt Size
*
Choose
Youth SM
Youth Med
Youth LG
Adult SM
Adult MED
Adult LG
Adult XL
Adult XXL
Adult 2XL
Adult 3XL
Adult 4XL
Camper Needs Improvement with...
*
Your answer
Camper Allergies
*
Your answer
Camper Health Issues
*
Your answer
Camper Medications
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone Number
*
Your answer
Guardian Name
*
Your answer
Guardian Phone Number
*
Your answer
Guardian Email Address
*
Your answer
Total Household Income
*
Choose
Less than $10,000
$10,000-$19,999
$20,000-$29,999
$30,000-$39,999
$40,000-$49,999
$50,000-$59,999
$60,000-$69,999
$70,000-$79,000
$80,000-$89,000
$90,000-$99,000
$100,000-$149,999
More than $150,000
Anything else you would like to ask or share can be written here.
Your answer
How did you hear about Hamm Camp?
*
Your answer
*
By checking this box, you, as the parent or guardian, allow your child to attend Hamm Camp. Hamm Camp is not liable for any injuries that may occur before, during, or after the camp.
Required
A copy of your responses will be emailed to the address you provided.
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