Kids Camp Registration

About The Camper:

Youth's Name(Required)
MM slash DD slash YYYY
Adult's Name (Parent/Guardian)(Required)
(Authorized to pick-up child, and primary emergency contact)
Email Address(Required)
Before & After camp care available for additional cost ($40/week)

Health History

Does Camper carry an EpiPen?
Will Camper need to take any medication while on site?
Please let us know of any special physical or behavioral needs or accommodations we should be aware of so that we can provide the best possible support and camp experience for our participants.

Additional Contacts

Who else is approved to pick up your youth end of day? (only names on this list will be allowed to do sign out)
Additional Contact 1
Additional Contact 2
Additional Contact 3

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