Family Camp Registration Form

Mommy & Me Camping Weekend Registration Form

November 4-6, 2022 * YMCA Camp Harrison * Boomer NC
Mommy Name:

First NameLast Name
Contact Number
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E-mail Address
example@example.com
Do you have any known medical or safety concerns?
Child One Name

First NameLast Name
Does this child have any known medical or safety concerns?
Child Two Name

First NameLast Name
Does this child have any known medical or safety concerns?
Child Three Name

First NameLast Name
Does this child have any known medical or safety concerns?
Emergency Contact Information

Please enter the name of adult who should be contacted in case of an emergency.
Relationship:

SiblingParentFriendOther
Full Name

First NameLast Name
Any questions or concern:
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Camp weekend registration (per person)Mom & Me Weekends are the perfect opportunity for your family and friends to unplug and spend time together at a local YMCA campground. At Mom & Me, everyone can adventure on the ropes course and climbing wall, hike beautiful trails, try target sports and see the lake by boat. Mom & Me Weekend includes cabin lodging-bunkbed style- with a group of 16 per cabin, meals, and exciting camp activities throughout the weekend. ******REGISTRATION FEE IS PER PERSON******** *********FEE IS NON REFUNDABLE******
$55.00 Quantity

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Mommy & Me Camping Weekend Registration Form