Summer Camp Application Form

Camper Name: First name：____Last name：____

Camper Age Group 7-10 11-14 15-18

Parent/Guardian Name: First name：____Last name：____

Parent/Guardian Email

Please fill in your phone number

Address: Street address：____ Street address line 2：____ City：____ State：____ Zip code：____ Country：____

What allergies does your camper have, if any?

What medication does your camper need to take, and at what time, if any?

Camper T-Shirt Size SMALL MEDIUM LARGE EXTAR LARGE OTHER____