Camp Registration Form

School Name
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Phone Number
Year in School
Year in School

Family Information
Parent/Guardian's Name

First NameLast Name
Contact Phone Number
E-mail Address
example@example.com

Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Relationship to Student

In 300 words or less, please describe your reasons for wishing to attend this camp.

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Camp Application for FeeCamp fee for 4 days
$50.00 Quantity

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