Child Name *

First Name

Last Name

Parent Guardian 1 Name *

First Name

Last Name

Parent Guardian 2 Name

First Name

Last Name

Additional Parent/Guardian

Please add any other adult who is considered legal guardian here.

First Name

Last Name

Child Birth Date *

MM

DD

YYYY

Please check here only if you DO NOT want your child in any camp photos.

I DO NOT want my child to appear in any camp photos.

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country