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Program Age Level (check all
that apply):
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Service Unit Name:
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School Name*:
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To register for camp, select a session code, then program and session dates. If a specific program is full, it will not be available as a choice.
Camp Choice #1:
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Session Code*:
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Bus Info:
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Camp Choice #2:
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Session Code*:
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Bus Info:
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Buddy Preference:
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First Name:
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Last Name:
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What best describes the camper?
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Ethnic Background:
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Guardian's Information:
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First Name*:
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Last Name*:
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Address*:
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Home Phone*:
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Email Address:
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Daytime Phone*:
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Cell Phone:
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Custodial Guardian #2:
First Name:
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Last Name:
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Daytime Phone:
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Cell Phone:
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Permission Slip:
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Click Here to download printable version. In order to assure your
child's place, the ORIGINAL signed version must be received at the council office
(US Mail or hand delivered) within five business days of this online submission. |
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Special Accommodations Needed:
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