2019 Summer Camp Registration
Email address *
Camper First Name *
Your answer
Camper Middle Name
Your answer
Camper Last Name *
Your answer
Nickname or Preferred Name *
What name does your camper prefer to be called?
Your answer
Phone *
Your answer
Gender *
Age *
School Grade Next Fall *
Birthday *
Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Camp Week *
Room Request
Please list any friends/siblings your camper wants to room with during summer camp.
Your answer
T-Shirt Size *
Payment Option *
*A limited number of partial Scholarships are available ONLY for those with FINANCIAL NEED. You can help a child attend camp this summer. Please consider giving towards our Scholarship Fund. Visit the support page to give!
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