Name* First Last GenderMaleFemaleBirthday* MM DD YYYY Current Grade*School Attending*Does your child have any allergies?*YesNoPlease List All Allergies*Does your child require any special accommodations?*YesNoWhat accommodations does your child need?* Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Individuals Authorized for Pickup* Emergency Contact NameEmergency Contact PhoneParent/GuardiansParent/Guardian Name* First Last Relationship*MotherFather How did you hear about us?*Which camp are you interested in?Robots, Volcanoes & Art CampFabric Art Creative CampPoetic Art CampTotal $ 0.00 CAD
