Asian Camp Counselor Registration 2019: Medical Form
Camp Dates: July 21st-27th Location: Lodestar, Wilseyville, CA

Thank you for taking the time to complete your online Registration! Please make sure all of your info is correct before submitting and submit your Registration only once.


Basic Information
First Name *
Your answer
Last Name *
Your answer
Date of Birth (MM/DD/YYYY)
Your answer
Gender *
Your answer
Address (Address, City, State, Zip) *
Your answer
Phone# (camper) *
Your answer
Parent Email *
Your answer
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