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Camper Name
*
First
Last
Camper Age Group
*
6-8 years old
9-12 years old
13-15 years old
Desired Cabin
Cabin 1
Cabin 2
Cabin 3
Cabin 4
Cabin 5
Does the camper have any known allergies?
*
Yes
No
Has the camper been camping before?
*
Yes
No
Emergency Contact Information
Please enter the name of the parent or guardian who should be contacted in the case of an emergency.
Relationship
*
Parent
Sibling
Relative
Friend
Name
*
First
Last
Email
*
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Questions or Comments
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