Camp Registration Form

Camper Information

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Please fill out one form per camper.

After submitting this form you will be redirected to a page where you can add each camp week to your shopping cart. If you are not redirected please check your popup blocker.
After completing your purchase you will be emailed an official registration form which will need to be signed and returned. If you do not receive a form within 5 business days please check your spam folder.
If you have any issues registering please reach out to our camp director Tara at .

First Name

Last Name

Date of Birth

Gender

School

2026/27 Grade Level

Known Allergies / Medical Conditions

Medications*

*For preserve staff to administer any medication on site (including, but not limited to Epi-Pens, Benadryl, inhalers, etc.) it must be in its original container with a doctor’s Rx. The Individual Plan of Care Form must be completed, along with one Medication Administration Form per medication.

Additional information you want staff to know about your child

In order to better help your child, please share any information or special circumstances regarding your child. This should include any social behavioral concerns, physical or medical issues, family situations, etc.

Camper placement request

Please note we do our best to accommodate all requests but cannot guarantee your child will be placed with another camper.

Parent/Guardian Contact Information

This will be the primary contact

First Name

Last Name

Relationship to Camper

Address

Address Line 1

Address Line 2

City

State

Zip Code

Mobile Phone

Home Phone

Emergency Contact #2

Please provide in addition to the primary parent/guardian listed above

First Name

Last Name

Relationship to Camper

Address

Address Line 1

Address Line 2

City

State

Zip Code

Mobile Phone

Home Phone

Emergency Contact #3

Please provide in addition to the primary parent/guardian and emergency contact listed above

First Name

Last Name

Relationship to Camper

Address

Address Line 1

Address Line 2

City

State

Zip Code

Mobile Phone

Home Phone

I understand that all required camp forms are due by June 1, 2026. I understand that forms received after this date will incur a $25 late fee.

I have read and agree to the Cancellations and Refunds Policy

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Camp Registration Form

Camper Information

Parent/Guardian Contact Information

Emergency Contact #2

Emergency Contact #3

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