Camper 1 Name *

First Name

Last Name

Camper 1 Birthday *

MM

DD

YYYY

Camper 1's friend request (A)

You will get to make new friends at camp. If you have a friend that your camper would like to be on a team with, list them here. We will do our best to honour all requests to put a camper with at least one friend if requested.

First Name

Last Name

Camper 1's friend request (B)

You will get to make new friends at camp. If you have a friend that your camper would like to be on a team with, list them here. We will do our best to honour all requests to put a camper with at least one friend if requested.

First Name

Last Name

Check this box below if you want to register a second camper

Yes, I'd like to register a 2nd camper

Check this box below if you want to register a third camper

Yes, I'd like to register a 3rd camper

Check this box below if you want to register a fourth camper

Yes, I'd like to register a 4th camper

Check this box below if you want to register a fifth camper

Yes, I'd like to register a 5th camper

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent / Guardian Name *

First Name

Last Name

Parent / Guardian Cell Phone *

Country

(###)

###

####

Emergency Contact 1 Name *

(Can be the same as the parent/guardian listed above)

First Name

Last Name

Emergency Contact 1 Cell Phone *

Country

(###)

###

####

Emergency Contact 1 Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact 2 Name *

First Name

Last Name

Emergency Contact 2 Cell Phone *

Country

(###)

###

####

Emergency Contact 2 Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Who has permission to pick up your Camper(s)? *

Name 1

First Name

Last Name

Who has permission to pick up your Camper(s)? *

Name 2

First Name

Last Name

Any pickup restrictions we need to know of? *

Ex. Restraining orders or other adults who are not permitted to pick up your Camper(s)

N/A

Yes, we have pickup restrictions

Photo/Video Consent *

Yes, I grant picture/video consent for my Camper(s) for future promotions of camp

Yes, I grant picture/video consent for my Camper(s) for in-house use only

No, please avoid taking pictures/videos of my Camper(s)