Guardian’s Name *

Please provide the guardian’s name for the teenager who is interested in attending amp camp

First Name

Last Name

My child is between the ages of 13-17 *

In our first year of amp camp we want to provide a place for teens to come together. We hope to grow the camp to younger participants in the near future.

Yes, my child is between the ages of 13-17

No, my child is 12 or younger, but we want to learn more

Phone *

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