M4 Campout Multiple Camper Form

M4 Campout

When: Friday, June 5th, 2020 @ 4 PM - Sunday, June 7th, 2020 @ 12 PM
Registration Deadline: Friday, May 31st, 2020

Ages: 7 years - 12 years
Multi-Camper Family Discount: $35 per camper
Water bottle and/or backpack available for purchase below.

Please fill out the fields for each camper separately. Upon checkout, you will be able to select how many campers you have and check out securely via PayPal. Please fill out all fields for each camper that is attending. If not applicable, please enter "n/a."

Register Multiple Campers Here (Register Individual Campers on the Individual Camper Form)

Camper #1 Name:*

Camper's Age (as of 6/2/2019)*

Grade Entering Fall 2019*

Known Medical Conditions:

List of Medications (if applicable)

Any Known Allergies:

Gender:*

MaleFemale

Camper #2 Name*

Camper's Age (as of 6/2/2019)*

Grade to be Entering*

Known Medical Conditions

List of Medications (if applicable)

Any Known Allergies

MaleFemale

Camper #3 Name

Camper's Age (as of 6/2/2019)

Grade to be Entering

Known Medical Conditions

List of Medications (if applicable)

Any Known Allergies

MaleFemale

Camper #4 Name

Camper's Age (as of 6/2/2019)

Grade to be Entering

Known Medical Conditions

List of Medications (if applicable)

Any Known Allergies

MaleFemale

Camper #5 Name

Camper's Age (as of 6/2/2019)

Grade to be Entering

Known Medical Conditions

List of Medications (if applicable)

Any Known Allergies

MaleFemale

Camper #6 Name

Camper's Age (as of 6/2/2019)

Grade to be Entering

Known Medical Conditions

List of Medications (if applicable)

Any Known Allergies

MaleFemale

Parent or Guardian Name:*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail*

Phone Number*

Area CodePhone Number

Other Contact/Emergency Contact Name*

Other Phone/Emergency Phone*

Area CodePhone Number

Authorization and release of liability (noted in packet) shall remain effective until terminated in writing.

Parent or Guardian Signature:

How many campers did you sign up? Please make your selections carefully. *

Registration Fee$35.00

Quantity

Water Bottle$10.00

Quantity

Backpack (Must purchase or bring from prior year)$7.00

Quantity

Total $0.00