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Camper Application
Name_________________________
Age__________________________
Gender_______________________
School_______________________
Grade Completed________________
Health Card Number__________________
Birthday____ /____ /_______ (MM/DD/YYYY)
Mothers Name___________________
Ocupation_____________________
Home Phone Number______ /_____ /________
Work Phone Number______ /_____ /________
Cell Phone Number______ /_____/________
Email_______________________
Fathers Name____________________
Ocupation_______________________
Home Phone Number______ /_______ /_______
Work Phoe Number_______ /_______ /_______
Cell Phone Number______ /_______ /_______
Email__________________________
Please Name 2 emergency contacts
Name_______________________
Home Phone Number_____ /_______/ _______
Cell Phone Number_____ /_______/ _______
Relation to Child_______________________
Name________________________
Home Phone Number_____ /______/ _______
Cell Phone Number_____ /______/ _______
Relation to Child______________________
Please Write any Medicle Conditons or allergies that your child has.
______________________________________________________
______________________________________________________
______________________________________________________
Please request one friend that your child wants to bunk with.
____________________________
Please note we cannot garuntee that your child will be with thier friend of choice.
