Clone of 2025 Camp Registration Form

Camp Registration Form

To book for a place in the the camp, you must complete the form below accurately.
Camper Name:

First NameLast Name
Birth Date:

MonthDayYear
Home Phone Number:

Area CodePhone Number
Mobile Number:

Area CodePhone Number
Email Address:
Desired Name Tag:
Primary Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Select Camp shirt size:
Please provide any medical or dietary restrictions you have:
Does your child require an EpiPen?
How did you hear about Camp?:

Family Information
Parent/Guardian's Name:

First NameLast Name
Contact Phone Number:

Area CodePhone Number
E-mail Address:
Alternative Individual (s) authorized to pick up camper.

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name

Emergency Contact Information
Emergency Contact Name:

First NameLast Name
Emergency Contact Phone Number:

Area CodePhone Number
Relationship to Student:

Your Reason For Attending This Camp
In 300 words or less, please describe your reasons for wishing to attend this camp.

0/300

My Products

Session 1 June 8-11 Product Image

Session 1 June 8-11$200.00

Session 2 June 15-18 Product Image

Session 2 June 15-18$200.00

Session 3 June 22-25 Product Image

Session 3 June 22-25$200.00

Enter coupon

Subtotal $0.00Tax $0.00Total $0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Should be Empty: