Camp Registration Form PayPal Checkout

Camp Registration Form
Camper Name:

First NameLast Name
Camper Age Group:
Does your child have allergies?

YesNo
Please specify
Has your child completed an outdoor camp before?

YesNo
Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in the case of an emergency.
Full Name

First NameLast Name
E-mail
example@example.com
Any questions or concern:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
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June 16th-20th
$125.00



June 23rd-27th
$125.00



Both weeks
$250.00



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.