Contact & Insurance Form

You must already be accepted to camp to use this form.  If you don't know if you're accepted then please contact us.
Camper Information
First Name:		Last Name:
Session:	Select Session One Commuter (7/27 - 7/30, 2008) Session One Resident (7/27 - 7/30, 2008) Session Two Day Camper (7/31 - 8/2, 2008)
Insurance Company:		Phone:
ID #:		Plan #:
Please Note Medical History/Concerns Here:
Parent/Guardian Contact Information
First Name:		Last Name:
Em. Phone:		E-Mail:
		**	Please complete all fields.