Parent's Name *

First Name

Last Name

Phone *

(###)

###

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Child's Name *

First Name

Last Name

2nd Child's Name

First Name

Last Name

Emergency Contact *

First Name

Last Name

Phone *

(###)

###

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By submitting the camp application, the parent or guardian certifies that all information provided is true. You expressly waive any and all claims against Thirteen Oh Eight Events LLC, it's managers, staff and representatives because of any injury or damage that may be incurred to the named applicant. You also authorize the camp to act in the best interest of each camper in the event of an emergency. *

I acknowledge