Camp Gian 2019 Camper Registration
Email address *
First Name? *
Your answer
Last Name? *
Your answer
Street Address? *
Your answer
City? *
Your answer
Zip Code *
Your answer
What is your T-Shirt Size? *
What is your gender? *
What's your Age? *
Your answer
What is your Date of Birth? *
MM
/
DD
/
YYYY
How many years have you been attending Camp Gian? *
Your answer
Emergency Contact Name: *
Your answer
Emergency Contact Relationship
Your answer
Emergency Contact Number: *
Your answer
Secondary Emergency Contact Name: *
Your answer
Secondary Emergency Contact Number: *
Your answer
Will you be staying overnight? *
Will you be taking any medication during camp? *
Your answer
If yes, please specify:
Your answer
Camper must be present all five days of camp. If there are any reasons why you would miss a day, please specify the reason and day.
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If you have any comments or suggestions for this years field trip, please let us know below:
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If you have any question or comment about Camp Gian, please let us know below:
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A copy of your responses will be emailed to the address you provided.
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