Medical Information
Does the camper have allergies including asthma?
Please explain on the field provided
Is the camper currently under medication?
Please provide the details, the name of the medication and period of intake

Contact Information in Case of Emergency
Name

First Name Last Name
Contact Number

Area Code Phone Number
Relation to camper
Name

First Name Last Name
Contact Number

Area Code Phone Number
Relation to camper

Payment
Total amount for chosen camps
I would like to pay

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USD Description
Signature of applicant or guardian representative

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Should be Empty: