Camp Elachee 2019: Rising K-6th Grade Registration

NUMBER OF ATTENDEES PARENT/GUARDIAN FIRST NAME PARENT/GUARDIAN LAST NAME ADDRESS TYPE Home Work School Other MAILING ADDRESS CITY STATE Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavat Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory ZIP CODE - EMAIL PREFERRED PHONE SECONDARY PHONE I am registering my grandchild on behalf of his/her parents. YES NO How Did You Learn About Camp Elachee? My Child(ren) is a Previous Camper Sibling is a Previous Camper Friend or Family Mailed Postcard School Flyer Elachee Web Site Social Media Newspaper Billboard Internet Ad