Alternate Pickup Form
Camper's Full Name
*
First Name
Last Name
Guardian's Full Name
*
First Name
Last Name
Guardian's Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Pick Up Person's Full Name
*
First Name
Last Name
Relationship to Camper
*
Alternate Pick Up Person's Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I authorize the above named person to pick up my camper from camp.
*
I agree
Guardian's Signature
*
Date of Authorization
*
-
Month
-
Day
Year
Date
Submit Authorization
Submit Authorization
Should be Empty: