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Camper Registration Form: Week 5: Intermediate
Camping Dates: July 24th - 29th - Ages 12 to 13
All camps begin on Sunday at 3pm and end on Friday at 12pm.
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* Anger obligatorisk fråga
Camper Information
Camper's Last Name
*
Ditt svar
Camper's First Name
*
Ditt svar
Date of Birth
*
MM
/
DD
/
ÅÅÅÅ
Gender
*
Male
Female
Address
*
Ditt svar
Name of school and grade
Ditt svar
Faith (if applicable - for statistical use only)
Ditt svar
Doctor's Name
Ditt svar
Doctor's Phone Number
Ditt svar
MCP Number
*
Ditt svar
Legal Custody
*
Both Parents
Mother
Father
Guardian
Obligatorisk
Cabinmate Request #1
This is not a guarantee that two campers will be in the same room.
Ditt svar
Cabinmate Request #2
This is not a guarantee that two campers will be in the same room
Ditt svar
T-Shirt Size - These are adult sizes. Registrations submitted after June 1st are not guaranteed their chosen size.
*
S
M
L
XL
Photo Consent
*
Your child may photographed or videoed at camp. Please indicate if photos or videos of your child may be used for program or promotion of the camp. Each child will be sent home with a camp photo from their week.
Yes - Photos/Videos of my child may be used
No - Photos/Videos of my child may NOT be used
Please indicate and give details in the field below if your child has any special dietary concerns.
Ditt svar
Other information
Please provide any other information you feel is necessary for the counselors of the camp to be made aware of in the space below.
Ditt svar
Parent/Guardian #1 Information
Parent/Guardian #1 Name
*
Ditt svar
Home Phone
*
Ditt svar
Cell Phone
Ditt svar
Work Phone
Ditt svar
Address if different from camper
Ditt svar
Email Address
*
Email is used for most of our correspondence
Ditt svar
Parent/Guardian #2 Information
Parent/Guardian #2 Name
Ditt svar
Home Phone
Ditt svar
Cell Phone
Ditt svar
Work Phone
Ditt svar
Address if different from camper
Ditt svar
Email Address
Email is used for most of our correspondence
Ditt svar
Alternate Emergency Contact
Please provide contact information for someone in the event that the Parent/Guardians listed previously are unavailable.
Name
*
Ditt svar
Contact Number
*
Ditt svar
Other Phone
Ditt svar
Relationship to camper
Ditt svar
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