Primary Contact First Name

Primary Contact Last Name

Primary Phone

Address

City

Country

State / Province

Zip / Postal Code

Email

Password:

In the camper's account information (accessible from your Account home page), for their name, put the name they would like to be called at camp (ex. Sam instead of Samuel). This is the name we will use. Leave Nickname blank. Leave Middle Initial blank.

Why did you choose Chatuga?

Other camps attended:

How did you hear about Camp Chatuga?

Name of Friend / Relative / Internet Source / Ad / Camp Fair, etc.

Siblings' names and ages who may be future campers:

Parent relationship:

Occupation