IGNITE CAMP REGISTRATION

Camp Ignite Summer Camp Early Registration

Complete the form below to hold your child's place in our Ignite Summer Camp 2025! In Spring of 2025, you will receive an email to the address you provide below to complete the official registration and pay the $75 Registration Fee. Please be sure to complete one child per form.
Camper Information
Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Health or Behavioral Conditions:
Drug Allergies or Other Allergic Reactions:
Dietary Needs/Restrictions:
Medication Taken Regularly:
Activity Restrictions:
Will child need food assistance (breakfast & lunch?)*

YesNo (will bring own food)
Parent/Guardian Information
Name*

First NameLast Name
Relationship
E-mail*
Cell Number*

Area CodePhone Number
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature

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Camp Ignite Summer Camp Early Registration