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


    Allergies*

    Medicines*

    Medical Conditions*

    Authorized Pick-up List*


    Signature*

    After clicking submit button, you will receive a confirmation e-mail.