VA 4-H Military Teen Adventure Camp Registration

Military Teen Camp Registration

Holiday Lake 4-H Educational Center
Camper Information
Camper’s Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Shirt Size (adult sizes)*

SmallMediumLargeXL2XL3XL
Does the camper have any allergies (including dietary needs), chronic illness, or medical conditions? If yes, please describe.*
List any information we as staff should be aware of to help your camper thrive at camp. *
Parent/Guardian Information
Name*

First NameLast Name
Home Number*
Cell Number*
E-mail*
example@example.com
Branch of Military*
Status*
Transportation
How will you be getting to camp?*
Will you be needing travel reimbursement*
Read over and complete the following forms
Code of Conduct

The Virginia 4-H Code of Coduct reviews expectations of the program. It should be reviewed and signed by both the parent/guardian and the camp participant. Printable version available on our website.

Virginia 4-H Standardize Code of Conduct for Programs/Events
Health History

Please provide detailed health information for determining appropriate supervision, support, and accomodations for camp.

Virginia 4-H Health History Form

My Products*

Teen RegistrationNon-refundable Registration Fee

$35.00

Total

$0.00

Military Teen Camp Registration