Nature Camp for the week of June 5

Parent/Guardian Full Name*

This field is required.

Home Address*

This field is required.

City & State*

This field is required.

Zip Code*

This field is required.

Home or Cell Phone Number*

This field is required.

E-mail Address*

This field is required.

Emergency Contact Name*

This field is required.

Emergency Contact Phone Number*

This field is required.

Name of another camper your child would like to be grouped with within 1-year age range (we will attempt to do so, but cannot guarantee)*

This field is required.

Camper Full Name*

This field is required.

Camper Age*

This field is required.

Camper Date of Birth*

This field is required.

Camper Gender*

This field is required.

Camper T-Shirt Size*

This field is required.

Camper Ethnicity (optional, but used for future grant opportunities)*

This field is required.

Camper Medical & Health Information*

This field is required.

Camper Allergies*

This field is required.

Restricitons for Camper*

This field is required.

Medications for Camper*

This field is required.

Tell us about your child!*

This field is required.

How did you hear about our Summer Camp?*

This field is required.

Camper Pick Up*

This field is required.

(Who will be picking this camper up)

Pick-Up Authorization Release*

This field is required.

Your e-signature

Liability Release*

This field is required.

Your e-signature

Photo Release*

This field is required.

Your e-signature

Parent/Guardian E-Signature*

This field is required.

Date of Signature*

This field is required.

My Account

Nature Camp for the week of June 5