Camp Participant InformationParticipants Name* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Date of Birth* Current Grade Level*Select One2nd3rd4th5th6th7th8th9thParent / Guardian Contact InformationParent Name* First Last Parent Email Address* Email Confirm Email Will you be traveling with your child?*YesNoParent Cell Phone*Emergency Contact Name* First Last (Other than parent/guardian listed above)Emergency Contact Phone*How did you hear about us?*Facebook adsInstagramFriend or familyFlyerYard signMagazine articleOtherArrival Flight InformationAirline*Flight #*Departure Airport (leaving from)*Arrival Airport (flying to)*Arrival Date* Arrival Time* : HH MM AM PM Departure Flight InformationAirline*Flight #*Departure Airport (leaving from)*Arrival Airport (flying to)*Departure Date* Departure Time* : HH MM AM PM Choosing Payment / SignatureWhat would you like to pay today?*Select OneDeposit OnlyPay in FullAfter completing this form, you will be redirected to PayPal to complete payment.Camp Waiver and Agreement*I have read the above ACKNOWLEDGMENT OF RISKS RELEASE AND INDEMNIFICATION AGREEMENT; by clicking the box below and adding my digital signature, I accept the terms and conditions of this Agreement in its entirety on behalf of the participant being registered on this form. I also attest that I am the parent or legal guardian of the participant being registered, and I have the legal authority to sign this Agreement on their behalf. I understand Signature*I accept the above ACKNOWLEDGEMENT OF RISKS RELEASE AND INDEMNIFICATIONWould you like to stay connected with the latest information and specials?Sure thing!No, thank youNameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.