Summer Camp.jpg
How did you hear about OUMC Summer Camp?*
Camper Name: *
First Name
Middle
Last Name
Name to be used at camp:*
Sex: *
Date of Birth:*
Child's Age: *
Grade during current school year:
Address: *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Home Phone:
Mother's Name: *
First Name
Middle
Last Name
Mother - TEXT?*
Mother's E-mail Address:*
Mother's Address: (If different from child)
Mother's Cell Phone:*
Mother's Employer:
Mother's Occupation:
Mother's Work Phone:
Father's Name: *
First Name
Middle
Last Name
Father's Cell Phone:*
Father - TEXT?*
Father's E-mail Address:*
Father's Address: (If different from child)
Father's Employer:
Father's Occupation:
Father's Work Phone:
Marital Status of Parents: *
Other Children In Family: (Please include FULL name, date of birth and grade in school) *
Contacts if parents cannot be reached: ~ Enter up to 3 ~ (Please include name, phone number and relationship to the child) *