Pioneer and Exploration Camps Registration Form

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Summer Camp Date:* Exploration FULL (June 20-24)Pioneer (June 6-10)Both NOT OPTION

Full Day or Half Day?:* Full Day ($250 per each camp)Half Day ($140 per each camp)

Parent or Guardian First Name:*

Parent or Guardian Last Name:*

Home Phone*:

Cell Phone*:

Email*

Address*

Emergency Contact Name*

Emergency Contact Phone*

Relationship to Camper*

Camper Name: First & Last*

Camper Birth Date*

T-Shirt Size
XS= CHEST: 16” LENGTH: 20.5”S= CHEST: 17” LENGTH: 22.0”M= CHEST: 18” LENGTH: 23.5”L= CHEST: 19” LENGTH: 25.0”XL: CHEST: 20” LENGTH: 26.5”ADULT SMALL: CHEST 18” LENGTH 28”

Allergies*

Medicines*

Medical Conditions*

Authorized Pick-up List*

Signature*