2019 August Combined Camp Registration

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August Kids Camp 8/2 - 8/6, 2019

Email *

Camper First Name *

Camper Last Name *

Parent First Name *

Parent Last Name *

Street Address *

City *

State *

Idaho

Other:

Zip (5 digit) *

Phone - Primary (no dashes) *

Phone - Secondary (no dashes) *

Is Camper currently enrolled 4-H Member? *

Yes

County *

Ada

Adams

Boise

Canyon

Elmore

Gem

Owyhee

Payette

Valley

Washington

Other:

Gender *

Male

Female

Ethnicity *

Caucasian

Hispanic or Latino

African American

Native American or Alaska Native

Native Hawaiian or Pacific Islander

Asian

Prefer Not to State

Demographics (Community) *

Farm

Town (under 10,000)

City (10,000-50,000)

City (More than 50,000)

Grade completed June 2019 *

Date of Birth *

YYYY

Age (as of January 1st, 2019) *

Payment Options $255 by 7/2, $295 after 7/2 *

PayPal - go to www.4hadventurecamp.com

Mail Check to 501 Main St, Caldwell ID 83606

Other:

T-Shirt Size (Adult Sizes) *

XXL

Roommate Request (must be reciprocal)

How did you hear about Camp? *

4-h

Friends/Family

Counselor

Google

Other:

Transportation to camp? Included with registration fee. *

Bus pick up - Ada County Extension

Bus pick up - Canyon County Extension

Bus pick up - Fruitland

Bus pick up - Emmett

Bus pick up - Horseshoe Bend

Driving up - arrive at 4 pm supervision not available until buses arrives, approximately 4 pm

Transportation from camp? Included with registration fee. *

Bus drop off - Ada County Extension

Bus drop off - Canyon County Extension

Bus drop off - Fruitland

Bus drop off - Emmett

Bus drop off - Horseshoe Bend

Driving home - Pick up between Noon and 12:30, No supervision available after 1 pm

I understand that the 4-H Adventure Camp Director and Adult Staff, with the assistance of camp counselors are responsible for making sure the safety and well being of my child is consistent for the entire camping time. I understand that if the above named participant does not conduct him/herself properly and in agreement with the policies and procedures, I will be notified and he/she may be sent home at my expense. Sign below. *

To enrich education through diversity the University of Idaho is an equal opportunity/affirmative action employer and educational institution. Persons with disabilities who require alternative means for communication or program information or reasonable accommodations need to contact Dana Gillespie in writing, danag@uidaho.edu or 322 E Front suite 220, Boise ID 83702, at least 1 week prior to camp.

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