Camper Registration | cgnkauai.com

Camper Info

How many campers are you registering? *

1st Camper

Cost = $250

If the fee is more than your family will be able to afford, please visit our scholarship info page to fill out a scholarship request form.

Name *

Gender *

Date of Birth *

Month

Day

Year

Street Address *

City *

State/Province *

ZIP / Postal Code *

Does this camper have any medical, dietary, or wellbeing concerns we should be aware of? *

Please describe *

2nd Camper

Cost = $225

Name *

Gender *

Date of Birth *

Month

Day

Year

Address *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Does this camper have any medical, dietary, or wellbeing concerns we should be aware of? *

Please describe *

3rd Camper

Cost = $200

Name *

Gender *

Date of Birth *

Month

Day

Year

Address *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Does this camper have any medical, dietary, or wellbeing concerns we should be aware of? *

Please describe *

4th Camper

Cost = $200

Name *

Gender *

Date of Birth *

Month

Day

Year

Address *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Does this camper have any medical, dietary, or wellbeing concerns we should be aware of? *

Please describe *

5th Camper

Cost = $200

Name *

Gender *

Date of Birth *

Month

Day

Year

Address *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Does this camper have any medical, dietary, or wellbeing concerns we should be aware of? *

Please describe *

Total Cost = $250

Total Cost = $475

Total Cost = $675

Total Cost = $875

Total Cost = $1075

Payment

PayPal @campregistrations - You can pay ahead of time! Send your payment amount for your camper(s) with your camper's name in the message.

Cash or check - Pay at camp when you drop off your camper(s).

PAYMENTS MUST BE MADE AT OR BEFORE CAMPER DROP-OFF ON JUNE 25TH.

1st Parent / Guardian

Name *

Phone Number *

Email Address *

2nd Parent / Guardian

Name *

Phone Number *

Email Address *

Emergency Contact

Name *

Phone Number *

Relationship to Camper *

Primary Care Doctor

Name *

Phone Number *

Additional Notes

Any additional notes