Camp Application - Lindell Study Center

Lindell Study Center

2018 Camp Galena Application
A separate application must be completed for each camper.
Each application must be accompanied by payment of a $100 non-refundable deposit.
All campers and CITs, once accepted, are required to provide a physical signed by a physician and dated after July 14, 2016.

* Indicates required field

Name of Parent Completing this Form *

First

Last

Camper Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Grade Entering 2018-2019 (select one) *

How did you hear about Camp Galena? *

Cabin Mate Request (limit one; no guarantees) *

Parent Address (if different from camper) *

Line 1

Line 2

City

State

Zip Code

Country

Parent Phone Number (if different from camper) *

Active Parent Email *

PARENT/GUARDIAN STATEMENT *

I verify that I am the parent/guardian of the above-named camper.

Comment *

CLICK HERE to Pay Deposit and Complete Application