Camper Registration and Consent Form

- - - - - Moksleivių Ateitininkų Stovyką - - - - 07/06/23 - 07/15/23

This form MUST be completed and signed by each individual participating in any camping activity at Camp Dainava or, if the individual is under the age of 18, by that individual's parent or legal guardian.

Is the individual under the age of 18 on today's date? *

Yes

No

Is this individual working as a staff member for Camp Dainava? (This includes, but is not limited to, counselors, teachers, kitchen staff, clergy, administrative, etc.) *

Yes

No

Camper's Information:

First Name *

Last Name *

Date of Birth * +

Sex *

2022-2023 School Grade *

Street Address *

Address Line 2

City *

State *

Zip Code *

Email Address *

T-shirt Size *

Ar jūs norėtumėte duoti Moksleivių ateitininkų įžodį stovykloje?

Taip

Ne

Parent's/Legal Guardian's Information:

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Mobile Phone Number *

Home Phone Number

Email Address *