Camp Sunrise Registration Form - may also use for Camp Snowball

Camper's Last Name

Camper's First Name

Camper Birth Date

Camper Age

Sex Sex Male Female

Number of weeks you would like to be enrolled (1-5)

June 25-30, Ages 8-55

July 02-07, Ages 8-30

July 9-14, Ages 8-55

July 16-21, Ages 8-55

July 23-28, Ages 8-55

Camper's Street Address

City

State

Zip

Name of person to contact concerning this registration

Registrant's Phone Number

Registrant's Email Address

Street Address

City

State

Zip

Name of Agency paying for camp week, if applicable

Agency Phone Number