Summer camp form

Inner Faith Summer Camp

* Indicates required field

Camper Name *

First

Last

Age & Grade *

Date of Birth *

Any Allergies *

Current Caregiver *

Caregiver Address *

Line 1

Line 2

City

State

Zip Code

Country

Caregiver Phone Number *

Emergency Contact *

Parent Drop off/Pickup: *

Days Attending *

Any Additional Information *

*Parents of youth ages 1-5 please provide the following items each week: zip-lock toiletry bag with pampers, wipes, and a change of clothes. Youth will also need a sleeping mat for nap time.*

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