Online Registration

Camper Information

First Name: *

Middle Name: *

Last Name: *

Date of Birth *

Gender *

Grade Completed Before Camp: *

To help us recognize your camper when they arrive please upload a head shot photo. This photo will also be used to help to identify your camper in photos during camp.

Photo Upload

Click or drag a file to this area to upload.

Are you affiliated with a summer campership program?

Please select one or more of the listed camp sessions below. There is a description of each session below once you select that session. Once you have made the choice simply click Next.

Registration for Summer 2022

Family Information Form

First Parent or Guardian

Second Parent or Guardian

Name *

First

Last

Name *

First

Last

Email *

Confirm Email

Email *

Confirm Email

Home Phone: *

Home Phone:

Cell Phone: *

Cell Phone:

Address

Address Line 1

City

State

Zip Code

Family Information

Family Status *

Custody *

Emergency Contact

Name *

First

Last

Relationship *

Home: Phone: *

Cell Phone: *

Insurance Information

Insurance Company Name:

Name of Insurance Policy Holder:

Insurance Company Policy #:

Insurance Plan or Group #:

Family Doctor Name and Phone Number

Family Dentist Name and Phone Number

Start Your Application

Begin your journey with the online application.

Camper Information

Registration for Summer 2022

Family Information

Emergency Contact

Insurance Information