Jr. Co-ed 2021
July 25-30 at Camp Wegesegum

Sunday Drop-Off at 2pm
Friday Pick-up at 12pm

Cost : $250

Contact us at Campwegie@gmail.com

Payment can be made via E-transfer to Campwegie@gmail.com or by cash or cheque at Camp Wegesegum.
Email address *
Name of Camper *
Gender
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Address
Birthday *
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DD
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YYYY
Age at time of Camp *
Email *
Name of Parent/Guardian *
Contact Phone Number *
Medicare Number *
Permission is given to provide my child with the following non-prescription medication as necessary during camp:
Does you child have any allergies or take any medication that would be administered at Camp? Please outline any special instructions.
Dietary restrictions
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We will try our best to pair you up with your buddy, Preferred cabin mate?
Photo Release: I hereby give consent to Camp Wegesegum Inc. to photograph and/or record my child through audio or video and to use this material in whole or in part through television, film, web page,multi-media presentation, radio, audiotape, videotape, display or in printed form for the promotion of Camp Wegesegum. I transfer any and all rights, including copyright, which mychild or I may have in this material to Camp Wegesegum. *
I understand that I will have to pay $$ upon arrival and sign to confirm this information *
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A copy of your responses will be emailed to the address you provided.
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