Name *

First Name

Last Name

Phone *

(###)

###

####

Emergency Phone *

(###)

###

####

Arrival Date

MM

DD

YYYY

Arrival Time

Hour

Minute

Second

AM PM

Departure Date

MM

DD

YYYY

Departure Time

Hour

Minute

Second

AM PM

I agree to... *

Bring my own utensils, plate, cup, bowl, and camp chair

Write my name on the above items

Help with after dinner camp chores on one or all of the three evenings.

Food Preference *

Vegan

Vegetarian

I'll eat anything

Date Submitted *

MM

DD

YYYY

Name *

First Name

Last Name

Phone *

(###)

###

####

Emergency Phone *

(###)

###

####

Arrival Date *

MM

DD

YYYY

Arrival Time *

Hour

Minute

Second

AM PM

Departure Date *

MM

DD

YYYY

Departure Time *

Hour

Minute

Second

AM PM

I agree to... *

Bring my own utensils, plate, cup, coffee mug, water bottle, etc.

Write my name on the above items.

Help with after dinner camp chores on one or all of the three evenings.

Food Preference *

Vegan

Vegetarian

I'll eat anything

Date Submitted *

MM

DD

YYYY

Name *

First Name

Last Name