2016 Camper Registration Form

Session Preference *
Please select a session preference below
Camper Information
For New Campers: Registration will not be processed without a case number
*Mandatory for new campers
If you selected "other", please enter the County below
Camper Name *
Camper Name
Please select an option from the pulldown menu
Address *
Address
Date of Birth *
Date of Birth
*NEW CAMPERS MUST BE 7-12 YEARS ONLY
If you selected "other", please enter the ethnic group below
For NEW or relocated campers only
Please select a size from the drop down menu
GAURDIAN / CARETAKER INFORMATION *
GAURDIAN / CARETAKER INFORMATION
Primary Phone *
Primary Phone
Secondary Phone
Secondary Phone
If you selected "other", please enter who the camper lives with
If you selected "other", please enter the primary language the camper speaks
Campers Name *
Campers Name
Camper 1 Name
Camper 1 Name