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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
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First
Last
Camper Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Grade Entering 2018-2019 (select one)
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Grade 6
Grade 7
Grade 8
Grade 9
T-Shirt Size (please pick one)
*
Child Medium
Child Large
Adult Small
Adult Medium
Adult Large
How did you hear about Camp Galena?
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Cabin Mate Request (limit one; no guarantees)
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Parent Address (if different from camper)
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Line 1
Line 2
City
State
Zip Code
Country
Parent Phone Number (if different from camper)
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Active Parent Email
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PARENT/GUARDIAN STATEMENT
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I verify that I am the parent/guardian of the above-named camper.
please check box
Comment
*
CLICK HERE to Pay Deposit and Complete Application
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