Registration Form – CMDA Camp

Contact Information

Email:
Email 2:
Phone (xxx-xxx-xxxx):
Address:
Address Line 2:
City:
State / Province / Region:
Zip / Postal Code:

Family Information

Family Name:

Person Information

Person 1 Name:
Person 2 Name:
Person 3 Name:
Person 4 Name:
Person 5 Name:
Person 6 Name:
Person 7 Name:
Person 8 Name:
Person 9 Name:
Person 10 Name:

Age at Start of Camp

Person 1 Age (leave blank for 18+):
Person 2 Age (leave blank for 18+):
Person 3 Age (leave blank for 18+):
Person 4 Age (leave blank for 18+):
Person 5 Age (leave blank for 18+):
Person 6 Age (leave blank for 18+):
Person 7 Age (leave blank for 18+):
Person 8 Age (leave blank for 18+):
Person 9 Age (leave blank for 18+):
Person 10 Age (leave blank for 18+):

Additional Information

Allergies (please list any food allergies your family may have):

Other comments:

Accommodation Preferences

Accommodation Preference #1:
Accommodation Preference #2:
CMDA Member:

By signing this form you acknowledge that the facilities of Camp Oshkidee are used by you, your family and your guests entirely at your own risk and that CMDS and Camp Oshkidee are not liable for any injuries, accidents or losses of any kind whatsoever.

Signature

Signature:
Date: