Which camp would you like to register for? (Only one child per form)

Quantity
Price
Total
Girls Anchor Camp - Deposit Only

August 17-19 Paying Deposit Only

X
$
40.00=
$
0

Girls Anchor Camp

August 17-19 Paying in Full

X
$
85.00=
$
0

Boys Anchor Camp - Deposit Only

August 24-27 Paying Deposit Only

X
$
40.00=
$
0

Boys Anchor Camp

August 24-27 Paying in Full

X
$
100.00=
$
0

Final Total:
$
0

Camper Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Parent/Guardian Information: This is used as emergency contact information and to better understand the families we serve. Please list information that is different than that which is listed in the Child information area above.

Parent/Guardian 1 Name
Parent/Guardian 1 Relationship to Brigade Member
Parent/Guardian 1 Address
Parent/Guardian 1 Cell Phone
Parent/Guardian 1 Home Phone
Parent/Guardian 1 Email
Parent/Guardian 1 Employer
Parent/Guardian 2 Name
Parent/Guardian 2 Relationship to Brigade Member
Parent/Guardian 2 Address
Parent/Guardian 2 Cell Phone
Parent/Guardian 2 Home Phone
Parent/Guardian 2 Email
Parent/Guardian 2 Employer

Demographic Information

By completing the following information, The Brigade is better able to understand the population we serve. All information in this application will be kept confidential.

Date of Birth
Annual Household Income
Number in Household
Ethnicity
  • Hispanic
  • Hmong
How did you hear about the Brigade?
  • Friend
  • Family Member/Neighbor
  • Ad in newspaper/magazine
  • Social Media
  • School Field Trip
  • Website
  • Other

Camp Specific Information

Please note that we are not able to recognize all requests.

I would like to be in a tribe with:

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code

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