Camper Interest Form

Camper Interest Form

Please fill out form carefully and accurately
New or Returning Camper *
Camper Legal Name *

First Name Middle Name Last Name Nickname
Birth Date *

Month Day Year
Gender *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/ Guardian E-mail *
example@example.com
Parent/ Guardian Mobile Number *
Parent/ Guardian additional contact number
Is your camper a part of a local church or youth group?

Yes No
If yes, which one?
Should be Empty: