INDIVIDUAL REGISTRATION FORM
NOTE: This form needs to be completed by every individual attending camp. This form may be photocopied and distributed to each individual in your group.
Group Name: Date of Event:
Individual's Name:
Birthdate: Age:
Street Address:
City: State: Zip:
Phone #
Emergency Contact Name: Relationship:
Phone Number: Alternate #
Please include a list of any known allergies or health conditions requiring Treatment, Restrictions, or other accommodations while at camp.
To Whom It May Concern:
I give permission for my child and/ or myself to participate in all weekend activities and to receive emergency treatment. The individual named above agrees to be included in any photographs and/or video publication.
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Date Signature of Adult Camper or Parent/Guardian of Minor Camper