Registration Form:
Camper Name __________________ Male____ Female____(check one)
Parent/Guardian Name______________ Parent/Guardian
Signature_____________
Address________________________________________________________________
City________________
Zip____________ Home
Phone_________________
Other Phone_________________
Grade Completed in June______
Birth date ___/___/___
Dept
of Corrections I.D.
______________________
If
not available, please explain
Please check the line, if you will need transportation to
Please check this line if you will need a scholarship or help paying
for camp fees ___
Camper name, address, and telephone number will be released to other campers and photographs may be taken for promotional purposes unless the dean is instructed otherwise by a Parent or Guardian.