Camper Information!

Name of Child #1

Age of Child

Any Allergies?

If your child is in the younger bunk, do they nap?

Name of Child #2

Age of Child

Any Allergies?

Name of Child #3

Age of Child

Any Allergies?

Any additional information you want to give about your child/children?

Parent 1

First Name

Last Name

Parent 2

First Name

Last Name

Phone

(###)

###

####

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Information

First Name

Last Name

Relationship

Phone

(###)

###

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Email

Pediatrician

First Name

Last Name

Insurance

Policy #