Campers Name____________________________________________________
Address:_________________________________________________________
City:______________________State:_______________ Zip:________________
Home Phone:_____-_____-______Cell Phone:_____-_____-______
E-Mail:__________________________________________________________
Age:_______Birth Date_____/_____/_______Grade starting in August_________

Guardian Name____________________________________________________
Address:_________________________________________________________
City:______________________State:_______________ Zip:________________
Home Phone:_____-_____-______Cell Phone:_____-_____-______
Work Phone:_____-_____-______ Fax _____-_____-______
E-Mail:__________________________________________________________

Camp Information:
Session to attend:____________Second option___________________________
Special requests?__________________________________________________
_______________________________________________________________
Special needs? i.e. dietary, allergies, medication, etc._______________________
_______________________________________________________________
Have you attended Summer camp before?If yes when and where?_____________
_______________________________________________________________
How did you hear about Camp Wake?_________________________________

Additional Information:
Years involved in Water Sports_______
What is you watersports experience? i.e. beginner, advanced, expert, pro
______________________________________________________________
List your goals while at Camp Wake.__________________________________
______________________________________________________________
______________________________________________________________