Dogwood Acres Summer Camp Registration 2021
Camper Registration
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Camper's Last Name *
Camper's Preferred First Name *
Age on First Day of Camp *
Gender *
Grade in Fall 2021 *
Name of sibling attending camp
T-Shirt Size *
Guardian's Last Name *
Guardian's First Name *
Guardian's Street Address or P.O. Box *
Guardian's City *
Guardian's State *
Guardian's Zip Code *
Guardian's Relationship to Camper *
Guardian's Home Phone *
Guardian's Cell Phone *
Does the guardian text? *
Guardian's Email Address *
Name and Number of an Alternative Emergency Contact Person *
Chaperone Who Will be in Bubble *
Camp Week Date Choice *
Which tier do you plan on paying? *
How much do you plan to deposit for the Trading Post? *
Scholarships *
Contact Director Ben Powell at ben@dogwoodacres.org ; once approved, fill out Scholarship Application on Parent Information Summer Camp Tab at dogwoodacres.org
The following individual(s) is/are legally restricted from seeing this camper:
Home Church if Any?
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