Camper Registration *Required two Parent/Guardian contact information Camper InformationHow many kids? Quantity(Required) Price: $125.00 Quantity Child Name(Required)First NameLast NameAgeGrade Add RemoveAddress(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian Information #1Name(Required) First Last Phone(Required)Email(Required) Parent/Guardian Information #2Name(Required) First Last Phone(Required)Email(Required) Phone(Required)Parent/Guardian Email(Required) Medical InformationFood Allergies: Please List Below(Required)Other Allergies: Please List Below(Required)Epi-Pen(Required) Yes No In Case of Emergency(if parents/guardian can't be reached):Insurance Provider/#(Required) Preferred Hospital(Required) Payment InformationProcessing Fee Price: $0.00 Total Credit Card(Required)
