Acorn Summer Camp
Camper Information
Name
First Name
Last Name
Which week are you signing up for?
June 2-4, 2026
July 21 -23, 2026
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
-
Month
-
Day
Year
Date
Gender
Food Allergies
Environmental Allergies
Medical Conditions
Prescription Medications
Other Health Information
Primary Contact
The person attending camp with the camper
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relation to Camper
Health conditions or Allergies we should be made aware of
Secondary Emergency Contact
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship to Camper
Submit
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