Winter Blast
Date: Monday, December 30, 2019 Time: 9 am - 4pm
This form is for registering one camper. If you want to enroll multiple campers please complete a separate registration for each individual.
Participant's First Name *
Your answer
Participant's Last Name *
Your answer
Participant's Gender *
Participant's age *
Your answer
Parent's name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email address (The registration confirmation will be sent here) *
Your answer
Primary phone number *
Your answer
Please share any health related issues or concerns below (e.g. allergies)
Your answer
Please include any additional information about your camper that we should know prior to the event
Your answer
Group Mate Request (Maximum 2)
We can only accommodate your request if the person(s) you are listing requests you as a group mate in return.
Group Mate #1
Your answer
Group Mate #2
Your answer
Payment of $35 (cash or check) is due at check-in the day of the event.
Click the "Submit" button below to complete your camper's registration.
Please call the office at 717-738-2233 with any questions regarding the event or your registration.
Submit
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