LaunchTrack

Early Bird 440.00 + 5% = - $462.00

Method of Payment:

MIDS CAMPER'S INFORMATION:

First name:

Last name:

Camper's Legal Name:

Grade as of September 2026:

Age (As of July 6th):

Birthdate (YYYY-MM-DD):

At birth my physical/biological sex was:

T-Shirt Size:

Returning Camper?:

What camp team were you on last year?:

Current Home Church:

We do our best to place campers with at least one friend. Please enter requests here (multiple names on a line will not be accepted)

Cabin Mate 1:

Cabin Mate 2:

Are you currently involved with any community or school sports teams? If yes, please list the teams:

PARENT/GUARDIAN INFORMATION (EMAIL PROVIDED WILL RECEIVE ALL COMMUNICATION)

Parent/Guardian Name:

Parent/Guardian Cell Number:

Home Phone Number:

Email:

Address:

Address2:

City:

Province / State:

Postal / Zip Code:

Approved Person For Pick (if different from Parent/Guardian listed above):

MEDICAL INFORMATION

Emergency Contact Name:

Emergency Contact Relation to Camper:

Emergency Contact Phone Number:

Care Card Number:

Medical Concerns:

Medications?:

List medications and dosage:

Allergies?:

List Allergies:

Does your camper require an Education Assistant while at school?:

Does your child/youth have any mental, emotional or behavioral designations or conditions (such as anxiety disorders, ADHD etc.) that we should know about?:

If yes, please describe the condion and type of support needed:

SPONSORSHIP

If you wish to be sponsored, you will need to reach out to your church to receive a promo code FIRST. The promo code will be used on the next payment page. This will be the only way for you to complete this registration form. *choose credit card as payment option, NOT check*