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Youth Camp Winter 25
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Give
Winter Camp 2025
DATE
: March 14-16
COST
: $100
LOCATION
: Hume SoCal Camp (Green Valley Lake, CA)
GRADES
: 6th-12th
Register Today
Cost: $100
To pay online,
click here and select Youth Winter Camp 25 in the fund section
First Name
Last Name
Gender
Male
Female
Birthdate
Month
January
February
March
April
May
June
July
August
September
October
November
December
Date
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Year
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2015
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2021
2022
2023
2024
2025
Name of Emergency contact
Emergency Contact Phone Number
Health Insurance Carrier & Policy Number (if none put None)
Does your child have any food, medication, or other allergies?
Yes
No
Allergies: check all that apply
Food
Medication
Other
None
Please LIST ALLERGIES INDIVIDUALLY & EXPLAIN below (PLEASE PROVIDE TYPICAL REACTION TO ALLERGEN) If none put None
Does your child have a special health or medical condition?
Yes
No
Please list all medical conditions and restrictions below (If none put None)
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