Camper's first name:

Camper's last name:

Email address:

Which week attending?

• Jr High School
• High school
• Kids camp

What activities would you like to include?

• Paintball ($10)
• High Ropes ($5)
• Low Ropes ($5)
• Nature Hike

Any allergies, or special instructions?

Please enter Camper's birthday: Month: January February March April May June July August September October November December Day: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year: 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007