Camper Information Form Camper's Name * First Name Last Name Camper's Age * 3 4 5 6 7 8 Camper's Gender Male Female Camper's Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Parent/Guardian Name * First Name Last Name Parent/Guardian Email * Parent/Guardian Phone * (###) ### #### Safety Information Who is authorized to pick up this camper from camp? * Please share each person's name, phone number and relation to the camper Emergency Contact #1 * First Name Last Name Emergency Contact's Relation to Camper * Emergency Contact's Phone * (###) ### #### Emergency Contact #2 * First Name Last Name Emergency Contact's Relation to Camper * Emergency Contact's Phone * (###) ### #### Medical Information Allergies Medications Special Medical Conditions Insurance Information We have received your camper’s information. Please make sure you have filled out the registration form and completed payment.
