Campership Registration Form

Campership Registration Form

For financial assistance
Camper full name *

First Name Middle Name Last Name Suffix
Parent/Gaurdian Email *
example@example.com
Second parent/guardian email
example@example.com
What session will your camper attend? *
How much can you pay? Full payments are due 2 weeks before session start
We NEVER turn away a camper due to lack of $
Family Inforamtion
Parent/guardian 1 *

First Name Last Name
Cell Phone *

Area Code Phone Number
Work Phone

Area Code Phone Number
Home Phone

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Mailing Address if different

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/guardian 2 Name

First Name Last Name
Cell Number

Area Code Phone Number
Work Number

Area Code Phone Number
Home Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mailing Address if differnt

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Other children in household
Configurable list *

Family Inforamtion