Hume Lake
Summer Camp

ELEVATE August 4 - 10
$950 Per Camper

To sign up,

Student Name

First Name

Last Name

Student Age

Gender

Male

Female

Registering Parent / Guardian's Name

First Name

Last Name

Parent's Email Address

Address

Which Camp Are You Interested In?

Medical Insurance Company

Policy Number

Emergency Contact

First Name

Last Name

Contact #

(###)

###

####

Please List Any Allergies

if applicable.

Are There Any Conditions That Might Hinder Your Student From Participating In Activies?

Parent / Guardian Signature

Pay Here

Middle School Hume Lake Ticket

$590.00

Quantity: