Wild & Rooted

Wild & Rooted

June 6, 2026 - The Camp at Sinking Creek
Name of Person Registering Family or Group*

First NameLast Name
Email Address *
example@example.com / to receive additional details about what to expect when you arrive for the event
Phone Number*

Area CodePhone Number
Names of All Adults Attending - all children must be accompanied by a parent/guardian the duration of the camp. Childcare will not be provided.
- Name of Child #1
  
  First NameLast Name
- Age of Child #1
- Youth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-Large
- Name of Child #2
  
  First NameLast Name
- Age of Child #2
- Youth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-Large
- Name of Child #3
  
  First NameLast Name
- Age of Child #3
- Youth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-Large
- Same Information for Any Additional Children Attending
  Name of Children, Age, and T-Shirt Size
- If you are a person with a disability and desire assistance or accommodation, please notify Michelle Poff at (540) 864-5812/TDD* during the business hours of 8:00 a.m. and 5:00 p.m. to discuss accommodations 5 days prior to the event. *TDD number is (800)828-1120.
  
  Virginia Cooperative Extension is a partnership of Virginia Tech, Virginia State University, the U.S. Department of Agriculture (USDA), and local governments, and is an equal opportunity employer. For the full non-discrimination statement, please visit ext.vt.edu/accessibility.
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