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Non Elks Kids Week Registration
Please complete the information below and hit submit. You will then need to provide a form of payment to reserve your child's spot at camp.
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Indicates required field
Which Session?
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Choose a session
Session 1: July 23-28, 2023
Session 2: July 30-August 4, 2023 - BOYS ONLY
Child's Gender
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Male
Female
Child's Age (at time of camp)
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Child's First & Last Name
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Name of Elks Child / Cabin Mate
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Street Address
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City
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State
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Zip
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Parent / Guardian First & Last Name
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Parent / Guardian First & Last Name
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Relationship
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Parent
Guardian
Grandparent
Other
Home Phone # (if no home #, use cell #)
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Relationship
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Parent
Guardian
Grandparent
Other
Primary Email Address
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Cell Phone # (if no cell #, use home #)
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Work / Alternate Phone #
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Has your child been away from home for longer than 2 days previously:
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Yes
No
Special Needs (Use Medical Conditions box below to explain checked items)
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Special Education Needs (e.g. para, EIP)
Special Dietary Needs (e.g. gluten free)
Significant Allergy
Special Medical Needs
Is your child a first time attendee or a returning camper:
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First time camper
Returning camper
Please describe any medical conditions, treatments or medications
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Is there anything else we need to know about your child
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