Camper Registration Form Camper Information Camper Name * First Name Last Name Camper Birthdate * mm/dd/yyyy MM DD YYYY Household Contact Information Parent Name * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Please type in information here * What week of camp would you like to register for camp? MEA Winter MLK Jr Pres Day Thank you!
