Application Form

Family Medical Insurance

Notify In Case Of Emergency

Medical Information

Disability or Chronic Disease:

Dietary Modifications:

Activities Limitations:

The information provided above is correct to the best of my knowledge, and the person herein described has permission to engage in all camp activities, except as noted. I have read the camp rules and agree that my child will abide by them. I hereby give my permission to the camp medical staff to secure proper treatment for the above child in case of injury or illness. 

Parent/Guardian Signature:

Date:

A $5 Registration Fee must be sent in along with this form in order for a spot to be reserved.  The remaining $65 is to be paid on the first day of camp.  This fee completely covers the cost of room and board, crafts, meals, and all class materials.  Campers may bring additional spending money for the camp store which sells soda, candy, snacks, etc.  $5 store credit cards are sold on the first day of camp for this purpose.