Name *

First Name

Last Name

Parent/Guarding Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Will you be paying by check or credit card? *

Upon submitting this form, you will be brought to our online payment portal to pay by credit card. Checks must be delivered on or before the date of the camp.

Credit Card

Check