Summer Camp Application Form

Question Title

* 1. Which camp are you interested in?

Camp A

Camp B

Camp C

Question Title

* 2. Which session are you interested in?

Session 1: [DATE-DATE]

Session 2: [DATE-DATE]

Session 3: [DATE-DATE]

Question Title

* 3. Camper Name

First name

Last name

Question Title

* 4. Camper Age Group

7-10

11-14

15-18

Question Title

* 5. Parent/Guardian Name

First name

Last name

Question Title

* 6. Parent/Guardian Email

Email address

Question Title

* 7. Parent/Guardian Phone

Country Code

Phone number

Question Title

* 8. Address

Street address

Street address 2

City

State

Zip Code

Country

Question Title

* 9. What allergies does your camper have, if any?

Question Title

* 10. What medication does your camper need to take, and at what time, if any?

Question Title

* 11. Camper T-Shirt Size

Small

Medium

Large

Extra Large

Other (please specify)

Question Title

* 12. Emergency Contact

First name

Last name

Question Title

* 13. Emergency Contact Email

Email address

Question Title

* 14. Emergency Contact Phone

Country Code

Phone number

Question Title

* 15. Is this person authorized to pick up your child in the event of an emergency?

Yes

For help setting up payments through SurveyMonkey, please visit https://help.surveymonkey.com/en/surveymonkey/create/accepting-payments/