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Camper Information
Please fill the form out once for every camper.
First Name:
 Last Name:
Nickname:
 Birth Date:
Age:
 School:
Physical Conditions:
Notes or Concerns:
Did anyone in your family previously attend Camp Smiley?
Alumnas Name:


Parent/Guardian Information
Parent/Guardian Name:
 Work Phone:
Cell Phone:
 Other Phone:
Email:
 Address:
Emergency Contact 1 Name:
 Emergency Contact 2 Name:
Emergergency Contact 1 Phone:
 Emergency Contact 2 Phone:
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