Summer Camp Registration
When: July 23-26, 2019
Contact us at hope1312co@gmail.com
Camper's Name *
Your answer
Camper's Date of Birth *
MM
/
DD
/
YYYY
Camper's Sex *
Camper's Age *
Your answer
Camper's Emotional Age *
Your answer
Camper's School
Your answer
Camper's Grade
Your answer
This child is living with: *
Name(s) of person(s) this child is living with:
Your answer
Moved in foster placement how many times:
Your answer
Explain any unusual family circumstances that make camp especially important for the child:
(for example: recent crisis, being moved in foster placement, severe economic needs, etc.)
Your answer
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