Register Your Child

Camp Information- Select Youth Week (Sun-Thurs) attending*

IBEW Local 47 - July 7th - 11th

Teamsters Local 1932 - July 21st - 25th

Teamsters JC42 - July 28th - Aug 1st

Camper Registration Form
This form must be completely filled out and signed by parent or guardian and returned to Youth Helpers

Childs Name*

First Last

Date of Birth*

Age*

Grade (going into)*

Gender*

Male

Female

Shirt Size

Address*

Street Address Address Line 2 City State ZIP Code

Preferred cabin mates (if any)

Cabin mates ARE NOT guaranteed. Campers are divided into cabins by age, gender and enrollement.

The following information is requested to help our counselors get to know a little bit about your child before he/she arrives at camp. The information will be kept confidential and is only shared with the counselors who will be working directly with your child. Please be thorough in order to help us provide your child with the best camp experience possible.

Does the camper go by a nickname?

Has the camper attended camp before?*

Yes

If yes, what type of camp (day or overnight) and for how many years?

Is there anything else you could tell us about the camper that would be helpful for their counselors to know?*

Yes

If Yes, what other information would you add?

Parent or Guardian Information

Parent / Guardian Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Cell Phone*

Home Phone

Email*

If parent or guardian is unavailable in an emergency, notify:

Name*

Relationship*

Phone*

Second Phone

Parent’s Signature*

Financial Information

Payment options*

Coupon

Camper Cost:

Price:

Total

• Union Affiliation if applicable for special Camp Weeks

Member Name

First Last

Local

Company

Please Read the Liability Waiver and Check the box below.*

I agree to the Liability and Waiver Agreement Terms

Please Read the Camp Rules and regulations and Check the box below.*

I agree to the Camp Rules and Regulations

To finalize registration, please sign your name below and click SUBMIT

Signature*

Comments

This field is for validation purposes and should be left unchanged.

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