Scholarships | MICHELE CARTER

* Parent/Guardian Full Name

* Address

* City

* State

* Zip Code

* Phone

* Email

Camper's Information

* Full Name

* Date of Birth

* Grade

* School

* Phone Number

Medical History

Allergies

* If yes, what kind of allergies?

* Recent Injuries

* If yes, what kind of injuries?

* Travelig with Medications?

* If yes, what kind of medications and what doseage?

Please note that all medications will be collected by a staff member and distributed by a staff member.

* Any special needs/situations we need to know about?

* Are you attending the Parent Session Thursday night?

* Overnight Camper

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