Camper Registration

Welcome to our Online Camper Application form! After completing this application you will be taken to our PayPal page to make your payment. By checking the box below, you agree that any photos taken of the camper named can be used in camp marketing materials.
 I agree to the above terms.

Session Date (required)

Camper's First Name

Camper's Last Name

Date of Birth

Photo of Camper

Camper's Age (As of June 15th, 2012)

Years

Months

Name of school

Grade in school (Completed as of 2011/2012 school year)

Parent/Guardian First Name

Parent/Guardian Last Name

Address

Address Line 2 (optional)

City

State

Zip

Home Phone

Cell Phone

E-mail address of Parent or Guardian

 I would like to receive correspondence by e-mail

What is the best way to reach you?

Are both parents living?
 Yes No

 Together Seperately No Response

Second Parent's/Guardian's Information (Optional)

First Name

Last Name

Address

Address Line 2

City

State

Zip

Home Phone

Cell Phone

E-mail address of Parent or Guardian

What activities will interest your daughter most?

How did you first learn about Skyland Camp?

Name and contact information of other parents who may be interested in Skyland

Did anyone in your family attend Skyland?
 Yes No

If so, who and what year(s)?

Camp Team:
 Tallyho Trossach New Camper

 I agree to make a non-refundable deposit ($500 for overnight camp/$300 for day camp) at the time of my application submission.