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Wild West 4-H Camp Lakeside
June 9th & 10th
Camper Age (on Jan 1): 7-9 years of age
Counselor Age ( on Jan 1): 14-18 years of age
Payment Deadline: May 3rd, 2021
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County
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Kearny County
Morton County
Thomas County
West Plains District
Wichita County
Wild West District
Camper, Counselor, Agent/Volunteer
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Camper
Counselor
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Childs Last Name
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Childs First Name
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Gender
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Age (Jan 1)
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Parent Name
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Phone Number
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Email Address
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TShirt Size
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YS
YM
YL
YXL
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Allergies/ Dietary Needs
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Other:
Additional Information:
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I acknowledge that I will make payment to my local extension office by May 3rd.
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