2019 Registration Form
Email address *
Camper Information
Last Name (Camper) *
Your answer
First Name (Camper) *
Your answer
Gender *
Grade (Entering in Fall 2019) *
Your answer
School
Your answer
Division (By grade entering) *
Choose your weeks. (The cost for individual days is $80 and $90 for trip days. If you choose to register for specific days send an email to camparielbh@gmail.com) There is a 5% sibling discount that applies for siblings attending the same weeks.
Week 1: June 17-June 21 ($325)
Week 2: June 22-June 28 ($325)
Week 3: July 1-July 5 ($325)
Week 4: July 8-July 12
Week 5: July 15-July 19
Week 6: July 22-July 26
Week 7: July 29-August 2
Week 8: August 5 - August 8
Parent information
Parent Last Name
Your answer
Parent First Name
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Additional Email Address
Your answer
Phone Number
Your answer
Alternate Phone Number (You can write multiple numbers with space in between)
Your answer
Please list any relevant allergies
Your answer
Additional Notes
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.