1) Please select which event this camper will be attending:
NO EVENT SELECTED! Junior Week #1 (June 13-18) : Ages 8-11, $135 per camper Junior High Week (June 20-25) : Ages 12-14, $135 per camper Senior High Week (June 27-July 2) : Ages 15-18, $135 per camper Junior Week #2 (July 4-9) : Ages 8-11, $135 per camper

2) Camper Information:

Camper's Full Name:
Street Address:
City: State: Zip Code:
Gender: Date of Birth:
Primary Phone:
Emergency Contact: Emergency Phone:
Parent or Guardian's Full Name:
If the address for the parent or guardian is different, write it below in the notes section.

3) Additional Information

-Please list any allergies to food, medication, or environment the camper has.
--Allergies--

-Please list any special medications the camper will require during his/her stay. NOTE that any medications
will need to be given to our staff when you arrive. Please enclose the medications in a zip-lock bag
along with written directions concerning dosage amounts and times.
--Medications--

-Please write any other important information here such as desired cabin mates or restricted activities.
--Notes--

4) Final Checklist:

To make sure your spot is reserved, the following must be done.
-submit this registration from and print the confirmation for your records
-print and fill out medical release form
-mail in the medical release form along with your deposit