Camp Ekar Registration Form

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Welcome to Camp Ekar! Please fill out the form below to begin your journey at camp. If you are registering multiple campers, please fill out a separate form for each individual.

Have you read our Camp Ekar Policies and Procedures? *

Yes

Name of parent/guardian *

Email address of parent/guardian *

Phone number of parent/guardian *

Address of parent/guardian *

Name of camper *

How old is your camper? *

Which week of camp would you like to attend? *

July 8 - 12

August 5 - 9

Is your camper attending Camp Ekar with a friend or sibling? If so, what is the name of that camper? We will do our best to keep siblings or friends together if desired, but note that campers are divided by age group (ages 8 - 11 and ages 12 - 16).

Have you already filled out a scholarship request form? Note that if you register for camp before receiving an award notice, we will not be able to retroactively apply scholarship funds. You can apply for a scholarship through this form. *

Yes

Name of emergency contact *

Phone number of emergency contact *

Does your camper have any allergies to food or medication? Please list all below. *

Does your camper have asthma? If yes, will your camper carry a rescue inhaler during the camp session? *

No, they do not have asthma.

Yes, they have asthma and will carry an inhaler.

Other:

Will your camper need to take any medication during their camp session? If yes, please describe. Note that our staff is NOT licensed to administer/dispense medications; therefore, campers are unable to take medication during camp hours unless it is administered directly by the parent or self-administered (written approval by parent required). *

Is there anything else you'd like us to know about your camper's heath?

Who would you like to be listed as authorized to pick your camper up? Note that only people on our authorized pick up list will be able to pick up your camper. You can add more people to your authorized pick up list later on by emailing us at ekar@ekarfarm.org. *

Have you paid for camp via GiveButter? You can find a link to pay here. *

Yes

Other:

Is there any other information you'd like to share about your camper?

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Ekar Farm. Report Abuse

Forms