Camper Basic Information
Email address *
Camper First Name *
Your answer
Camper MI
Your answer
Camper Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age (on June 3) *
Your answer
Current School *
Your answer
Grade in Fall 2019 *
Your answer
Camper T-shirt Size *
With whom does the student reside? *
Your answer
Parent/Guardian Name(s) *
Your answer
Parent/Guardian Address *
Your answer
Parent/Guardian Email Address(es) *
Your answer
Home Phone *
Your answer
Work Phone
Your answer
Cell Phone
Your answer
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