Registration Information

• Ticket Name

  Camper Name

  Age*

  Grade*

  Gender* Male Female

  Shirt Size * Youth Medium Youth Large Youth XL Adult Small Adult Medium

  Legal Parent/Guardian Name

  Address*

  City*

  State* AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY

  Postal Code/Zip*

  Email

  Emergency Contact*

  Phone*

  Relationship*

  Emergency Contact*

  Phone*

  Relationship*

  Roommate Choice (If Staying Overnight)

  Deposit Type -If you are putting down a deposit please select which type of camper you will be. If you are paying in full leave this option blank. Day Camper Overnight Camper

  Please Describe Any Relevent Medical History

  Please check box if you agree to the medical release terms (located at the end of the camp description above)* I AGREE