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Authorized Camp Pick-up Form
"
*
" indicates required fields
Step
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of
4
25%
Camper's Full Name
*
First
Last
Camper's DOB
*
Month
Day
Year
Name of person filling out this form
*
Email
*
Which Camp is your camper participating in?
*
Adventure Camp
Survival Camp
Nature Camp
STEAM
Rock, Ride, Paddle
Kayak 1
Kayak 2
Kayak 3
Select all that apply
Which week(s) of Adventure camp will they be attending?
*
Week 1 (6/5 - 6/9)
Week 2( 6/12 - 6/16
Week 3 (6/19 - 6/23)
Week 4 (6/26 - 6/30)
Week 5 (7/3 - 7/7)
Week 6 (7/10 - 7/14)
Week 7 ( 7/17 - 7/21)
Week 8 (7/24 - 7/28)
Week 9 (7/31 - 8/4)
Week 10 (8/7 - 8/11)
Week 11 (8/14 - 8/18)
Week 12 (8/21 - 8/25)
Select all that apply
Which week(s) of Survival camp will they be attending?
*
Week 3 (6/19 - 6/23)
Week 4 (6/26 - 6/30)
Week 6 (7/10 - 7/14)
Week 7 ( 7/17 - 7/21)
Week 8 (7/24 - 7/28)
Week 9 (7/31 - 8/4)
Week 10 (8/7 - 8/11)
Week 11 (8/14 - 8/18)
Select all that apply
Which week(s) of Nature camp will they be attending?
*
Week 3 (6/19 - 6/23)
Week 4 (6/26 - 6/30)
Week 6 (7/10 - 7/14)
Week 7 ( 7/17 - 7/21)
Week 8 (7/24 - 7/28)
Week 9 (7/31 - 8/4)
Week 10 (8/7 - 8/11)
Week 11 (8/14 - 8/18)
Select all that apply
Which week(s) of STEAM camp will they be attending?
*
Week 3 (6/19 - 6/23)
Week 4 (6/26 - 6/30)
Week 6 (7/10 - 7/14)
Week 7 ( 7/17 - 7/21)
Week 8 (7/24 - 7/28)
Week 9 (7/31 - 8/4)
Select all that apply
Which week(s) of Rock, Ride, and Paddle camp will they be attending?
*
Week 2 (6/12 - 6/16)
Week 3 (6/19 - 6/23)
Week 8 (7/24 - 7/28)
Week 9 (7/31 - 8/4)
Select all that apply
Hidden
Which week(s) of BC camp will they be attending?
*
Week 4 (6/26 - 6/30)
Week 7 (7/17 - 7/21)
Select all that apply
Which week(s) of Kayak 1 camp will they be attending?
*
Week 1 (6/5 - 6/9)
Week 2( 6/12 - 6/16
Week 3 (6/19 - 6/23)
Week 4 (6/26 - 6/30)
Week 5 (7/3 - 7/7)
Week 6 (7/17 - 7/28)
Week 7 ( 7/17 - 7/21)
Week 8 (7/24 - 7/28)
Week 9 (7/31 - 8/4)
Week 10 (8/7 - 8/11)
Week 11 (8/14 - 8/18)
Week 12 (8/21 - 8/25)
Select all that apply
Which week(s) of Kayak 2 camp will they be attending?
*
Week 2( 6/12 - 6/16
Week 4 (6/26 - 6/30)
Week 7 ( 7/17 - 7/21)
Week 9 (7/31 - 8/4)
Week 11 (8/14 - 8/18)
Select all that apply
Which week(s) of Kayak 3 camp will they be attending?
*
Week 3 (6/19 - 6/23)
Week 6 (7/17 - 7/28)
Week 8 (7/24 - 7/28)
Week 10 (8/7 - 8/11)
Week 12 (8/21 - 8/25)
Select all that apply
Hidden
Which week(s) of LIT camp will they be attending?
*
Week 3 & 4 (6/19 - 6/30)
Week 6 & 7 (7/17 - 7/28)
Select all that apply
Campers may only leave with an authorized person aged 16 or older. As indicated on the Authorized Camp Pick-up Form and carrying a valid ID. If your camper will be driving themselves to/from camp, please put their information as an authorized pick-up.
Full Name
*
Relationship to Child
*
Cell Phone
*
Would you like to add another authorized pick-up?
Yes
Full Name
*
Relationship to Child
*
Cell Phone
*
Would you like to add another authorized pick-up?
Yes
Full Name
*
Relationship to Child
*
Cell Phone
*
Would you like to add another authorized pick-up?
Yes
Full Name
*
Relationship to Child
*
Cell Phone
*
Would you like to add another authorized pick-up?
Yes
Full Name
*
Relationship to Child
*
Cell Phone
*
Would you like to add another authorized pick-up?
Yes
Full Name
*
Relationship to Child
*
Cell Phone
*
Would you like to add another authorized pick-up?
Yes
Full Name
*
Relationship to Child
*
Cell Phone
*
Would you like to add another authorized pick-up?
Yes
Full Name
*
Relationship to Child
*
Cell Phone
*
By checking this box, I attest that all the information above is accurate.
*
All the information is accurate.
Signed and filled out by:
*
First
Last