SUMMER CAMP
2025
Parent's First Name
*
Parent's Last Name
*
Phone
*
Email
*
Campers's Name
*
Choose Camp Week(s)
*
Summer Camp Week I (June 16-20)
Summer Camp Week II (June 23-27)
Summer Camp Week III (July 28- Aug 1)
Summer Camp Week IV (Aug 18-22)
Camper T-Shirt Size - choose one
*
Camper T-Shirt Size - choose one
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
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Student’s Medical History/Conditions
*
MEDICAL INSURANCE COMPANY NAME
*
POLICY NUMBER AND GROUP NUMBER
*
Print Name of Parent/Guardian
*
Signature of Parent/Guardian 1
*
Clear
Please Upload a copy of your driver's license
*
Please Upload a copy of your driver's license
Submit
