MVSKOVLKE PLAY SUMMER CAMP REGISTRATION CARD 2026

MVSKOVLKE PLAY SUMMER CAMP REGISTRATION CARD 2026
The Diabetes Prevention Program for the Muscogee Nation will offer FIVE different 2 DAY SUMMER YOUTH CAMPS that stress healthy lifestyles and diabetes prevention.

These camps will be FREE to any American Indian youth 10 - 15 YEARS OF AGE. Campers must have a chart at one of the Muscogee Nation Clinics or have a CDIB card. Each camp will take the ﬁrst 35 youth to sign up and priority will be given to 1st time campers.
Attendee Information

Please fill name and contact information of attendees.
Name of Camper

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Age as of July 1st, 2026
(10 - 15 only)
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
First time camper?
CDIB card?
Does the camper have diabetes?
Does your child have allergies of any kind?
If so, explain.
Requires medication?
Does your child have other health concerns?
If so, explain.
Camp Location (MARK ONE ONLY)
Completing this form does not guarantee enrollment. All registration cards need to be completed and turned in at least one week before camp begins to allow a timely manner for processing acceptance.

If you have questions, please contact Cheryl Aguilar at:

TEXT 918-758-6910
OFFICE PHONE 918-756-2240 EXT. 4402
EMAIL cheryl.aguilar@creekhealth.org
Should be Empty:

Attendee Information