Child's Information

Date of Birth
Country
State / Province*
Address
City
Parent Email*
Confirm Email*

Guardian Information

We will send updates and reminders prior to the event, so please include the e-mail address you check most often.

Guardian #1 Name/ Relationship
Guardian #1 Cell Phone (610-xxx-xxxx)
Guardian #1 E-Mail
Guardian #2 Name/ Relationship
Guardian #2 Cell Phone (610-xxx-xxxx)
Guardian #2 E-Mail
Lives with
Emergency Contact Name/ Relationship
Emergency Phone (610-xxx-xxxx)

Medical Information

Medical Conditions
Allergies
Medications
Dietary Restrictions

Cabin Assignments

Is there a friend or Counselor your child would like to share a cabin with? *Friends must be the same age & gender. *Requests are NOT GUARANTEED. We will do our best.

Cabin Request

IMPORTANT NOTE

HOW TO COMPLETE CAMP REGISTRATION

 

STEP 1: SUBMIT THIS ON-LINE FORM.  THIS TEMPORARILY HOLDS YOUR SPOT UNTIL YOU SEND YOUR FORMS AND PAYMENT.

 

STEP 2: PRINT THE CAMP PACKET PDF. COMPLETE ALL FORMS.

 

STEP 3: MAIL YOUR FORMS, PHOTO, INSURANCE COPY, AND FEE OR VISIT OUR REGISTRATION DAYS IN CHESTER.

 

 

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