Camper's Name *

Session Camper Registered For: *

Camper's Birth Date *

Camper's Age: (while at Camp) *

Gender

Parent Name *

Email *

Bunk Preference *

Do you have any friends you would like to dorm with?

If yes, please list the name of friend(s) below.

Friend Request No. 1

Friend Request No. 2

Friend Request No. 3

Who is permitted to pick up your child? #1 (List yourself first)

Name *

Phone Number *

Relation to Child: *

Who is permitted to pick up your child? #2

Name

Phone Number

Relation to Child

Who is permitted to pick up your child? #3

Name

Phone Number

Relation to Child

Who is permitted to pick up your child? #4

Name

Phone Number

Relation to Child

Please click only once

Dorm Assignment & Check Out Form