Northwest Youth Camp Registration

Name *

First

Last

Phone Number:

Email *

What's the best way to reach you? (Email, Text, Discord…) *

Please list any food allergies you might have: *

Date of birth *

If over 21, would you be willing to be a chaperone?

• Yes
• No

If over 21, would you be willing to be a a driver?

• Yes
• No

If under 18 – Parent/Guardian Name (Please put N/A if camper is over 18) *

First

Last

you under under

If under 18 – Parent/Guardian Email (Please put N/A if camper is over 18) *

If under 18 – Parent/Guardian Phone (Please put N/A if camper is over 18) *

Any comments or questions?

Submit