Registration - IECOC Youth Camp 2018
Email address *
Last name, First Name *
Your answer
Age *
Your answer
Gender *
Your answer
Email of participant (if different from person registering)
Your answer
Phone number *
Your answer
Is this participant a camp leader? *
If under 18, name of a parent/guardian
Your answer
Any allergies (including non-dietary) or dietary restrictions (e.g. vegetarian, lactose-intolerant, etc.)?
Your answer
Any medical condition(s) or disability? If so, please describe and list any medication and/or accessibility needs relevant during the camp
Your answer
Emergency contact name(s) *
Your answer
Emergency contact phone number(s) *
Your answer
Method of payment *
Will you be coming by bus with IECOC? *
How long will you be staying at camp? If part time, please fill the "other" option with the *specific days* you will be staying *
List up to 5 people you would like to stay with in your cabin (no guarantee, but priority given to those who have mutually selected each other). If no preference, write "N/A" *
Your answer
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