CampiCaribbean2018form

iCaribbean Storytelling Siblings 2019

"A cultural exchange for children."
Student's Information
Student's Name

First NameLast Name
Birth Date

MonthDayYear
Age
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of School
Parent/Guardian Information
Name

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the camper prescribed an inhaler? If yes, please explain any instructions.
Should be Empty:

iCaribbean Storytelling Siblings 2019