2019 Brighton Girls Camp Registration Info
Welcome to Brighton Girls Camp Online Registration Entry!
All requested registration information is required for submission. You will receive an email confirming your registration
STAKE OR GROUP ATTENDING WITH *
Select one from the drop-down below. Only select Mountaineer if you are older (14-15)
WEEK ATTENDING BRIGHTON CAMP *
Select your preference week from the drop-down below. Put your other week preferences in "Any other information.." section at the end of the form
CAMPER'S FIRST NAME *
Your answer
CAMPER'S LAST NAME *
Your answer
CAMPER'S BIRTHDATE *
ATTENTION: Please verify correct birth year. The form will default to 2019
MM
/
DD
/
YYYY
CAMPER'S AGE WHEN ATTENDING CAMP - SELECT ONE *
CAMPER T-SHIRT SIZE *
Each camper will receive an ADULT-SIZE T-shirt with their registration Select shirt size from the drop-down below
BUNK-MATE CHOICE
(Not required) First Name and Last Name - Bunk-mates must request each other to be considered.
Your answer
PLEASE INDICATE IF CAMPER IS A 1st OR 2nd YEAR BEEHIVE *
PLEASE INDICATE IF THIS IS CAMPER'S 1st or 2nd YEAR AT BRIGHTON *
CAMPER LIVES WITH *
(Please check one)
CAMPER RELIGION
Home Address of Camper *
Please enter camper's Home Address
Your answer
Home Ward of Camper *
Please enter camper's ward name
Your answer
Home Stake of Camper *
Please enter camper's stake name
Your answer
1st CONTACT NAME *
First and Last Name - please list one parent or guardian as the contact person for this camper. This person will be the primary contact for all communication
Your answer
1st CONTACT - Relationship to Camper *
Your answer
1st CONTACT - Cell Number *
THIS WILL BE THE PRIMARY EMERGENCY CONTACT Include area code: use this format _ _ _ - _ _ _ - _ _ _ _
Your answer
1st Contact Email address *
Please enter email of first contact for a camper. All email communication from Brighton will be through this email
Your answer
2nd CONTACT PERSON *
First Name / Last Name of other parent or person to contact if 1st Contact person can't be reached
Your answer
2nd CONTACT - Relationship to Camper *
Your answer
2nd Contact Email address *
Please enter email of second contact for a camper
Your answer
2nd CONTACT - Cell Number *
Include area code: use this format _ _ _ - _ _ _ - _ _ _ _
Your answer
3rd CONTACT PERSON
First Name / Last Name of other parent or person to contact if 1st or 2nd contact can't be reached
Your answer
3rd CONTACT - Relationship to Camper
Your answer
3rd CONTACT - Cell Number
Include area code: use this format _ _ _ - _ _ _ - _ _ _ _
Your answer
Camper Height *
Please enter camper height in feet and inches (4' 11")
Your answer
Camper Weight *
Please enter camper weight in pounds
Your answer
HEALTH INSURANCE COVERAGE
Insurance is NOT required to attend camp
Insurance Company
Your answer
Insurance Group # or ID #
Your answer
Policy Holder
Your answer
FOOD ALLERGIES/DIETARY CONCERNS
Please check any food CONCERNS or chose "other" to add anything not listed
MEDICAL ALLERGIES/OTHER ALLERGIES
Please check any ALLERGIES - List medications in "Other"
Mental Health
Select all conditions that apply to your camper
Medical General
Select all conditions that apply to your camper. Use the "other" option for short explanations. Questions and communications about medical conditions can be addressed by email to: firstaidscrubs@brightonldscamp.org
Physical Limitations/Restrictions
Your answer
OTC MEDICATION CONSENT *
Some OTC medications provided by Brighton are: Tylenol(acetaminophen), Advil (Ibuprofen), Benadryl (antihistamine), Allertec (cetirizine), cough drops, TUMS (antacid). Campers may carry their own Over The Counter Medications, but CANNOT share ANY meds with other campers.
List of Medications
Please list all camper prescription medications and dosages
Your answer
ANY OTHER INFORMATION?
If you have other preferences on weeks, put them here. Just enter something like: Week #4, #2, #6 in your order of preference. We will be contacting you if there is an issue. Is there other information you think would be good for us to know about this camper?
Your answer
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