Step 1: COMPLETE THE FORM

2019 Southern Oregon Summer Camp
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2019 Tillamook Summer Camp
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2019 Portland Summer Camps - Moved From Waitlist
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2019 Warrenton Summer Camp
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Would you like to donate money toward a scholarship for another camper? The number of scholarships we can give depends upon how many sponsorships we receive.  If you can, please consider donating towards a scholarships for another camper.

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Yes, Please!
PARENT INFORMATION
Parent 1 Name *
Parent 1 Name
Parent 1 Phone *
Parent 1 Phone
Parent 2 Name
Parent 2 Name
Parent 2 Phone
Parent 2 Phone
Home Address *
Home Address
FOSTER PARENTS ONLY:
If you are a foster parent, we have a limited number of rides we can offer to get your child to and from camp. There is no guarantee, but are you in desperate need of rides to or from camp for your child?
FIRST CHILD INFORMATION
(1) Child's Name *
(1) Child's Name
(1) Date of Birth *
(1) Date of Birth
(1) Will camper 1 wear glasses at camp?
Child's ethnicity or race (for funding purposes)
Name of the school the camper will attend in the fall.
The grade the camper will be in in the fall.
For example, if your child has temper issues, give us some tips that will help us manage, or if your child is dyslexic, support us in making sure we help your child feel included.
SECOND CHILD INFORMATION
(2) Child's Name
(2) Child's Name
(2) Date of Birth
(2) Date of Birth
(2) Will camper 2 wear glasses at camp?
Child's ethnicity or race (for funding purposes)
What school camper will attend next fall.
What grade camper will be in next fall.
For example, if your child has temper issues, give us some tips that will help us manage, or if your child is dyslexic, support us in making sure we help your child feel included.
THIRD CHILD INFORMATION
(3) Child's Name
(3) Child's Name
(3) Date of Birth
(3) Date of Birth
(3) Will camper 3 wear glasses at camp?
Child's ethnicity or race (for funding purposes)
What school camper will attend next fall.
What grade camper will be in next fall.
For example, if your child has temper issues, give us some tips that will help us manage, or if your child is dyslexic, support us in making sure we help your child feel included.
FOURTH CHILD INFORMATION
(4) Child's Name
(4) Child's Name
(4) Date of Birth
(4) Date of Birth
(4) Will camper 3 wear glasses at camp?
Child's ethnicity or race (for funding purposes)
What school camper will attend next fall.
What grade camper will be in next fall.
For example, if your child has temper issues, give us some tips that will help us manage, or if your child is dyslexic, support us in making sure we help your child feel included.
SCHOLARSHIP INFORMATION
Does your family qualify for free or reduced lunch?
EMERGENCY CONTACT INFORMATION
Not person filling out form--we will consider the parent(s) as first emergency contact(s).
Emergency Contact *
Emergency Contact
Emergency Phone *
Emergency Phone
FRIEND LIST
If your child is attending camp with friends, please list them here. We will try our best to put them in the same group, however this is not always possible.