CampOut 2019 Registration Form
Email address *
First Name *
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Last Name *
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Full Address *
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City *
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State *
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Postal Code *
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Phone Number *
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Email Address *
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Birthday *
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Current Age *
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Race *
Ethnicity *
Preferred Pronouns *
Referring Organization (if applicable) *
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Emergency Contact Name *
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Emergency Contact Phone Number *
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Emergency Contact Relationship to You *
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Emergency Contact Email Address *
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Emergency Contact Relationship *
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Can we say were calling from Pridelines? *
Any Medical Information We Should Know About? *
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Any Medications We Should Know About? *
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Can You Swim? *
Mental Health History *
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Accessibility Needs (Accessibility Accommodations) *
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Allergies?
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Would you like to stay in a Trans Only Cabin?
Dietary Restrictions?
Do you need a ride to CampOUT?
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